title: Hepatic trauma: analysis of the treatment with intrahepatic balloon in a university hospital of Curitiba.
abstract: OBJECTIVE
  The authors discuss the surgical strategies in the management of complex penetrating hepatic lesions through liver balloon tamponade.
  
  
  METHODS
  Eighteen patients who received care in a trauma referral center in southern Brazil over the last 5 years were selected retrospectively. Data and variables evaluated were age, sex, hepatic injury grade and location, amount of saline solution filling the balloon and the length of time it was kept in place, associated injuries, the nutritional therapy instituted, hem concentrate transfusion, complications, antibiotics use, ICU need and length of hospital stay.
  
  
  RESULTS
  All patients were male with an average age of 22.5 years (18-48). Gunshot wounds were more prevalent than stab wounds and their most common locations were the thorax and thoraco-abdominal regions. The m most commonly associated injury was in the diaphragm, and Couinaud segment VIII was the most often injured hepatic region (29.6%). Seven patients (38.9%) survived and the most common complication were biliary fistulae (42.8%). From the eleven deceased patients (61.1%), 6 died on the day of admission, 3 stayed for 18.6 days in hospital and the others died on the 2nd and 3rd postoperative days.
  
  
  CONCLUSIONS
  Transfixing hepatic lesions are usually difficult to manage and carry high morbidity and mortality rates. The use of intrahepatic balloon tamponade can be useful as a therapeutic tool, but not rid of complications, and for that reason it has specific and selected indications.
authors.affiliation: Clinics and Surgery, PUC-PR, Brazil.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Smaniotto
authors.forename: Luiz Carlos Von
authors.initials: LC
authors.lastname: Bahten
authors.forename: Dorivam Celso
authors.initials: DC
authors.lastname: Nogueira Filho
authors.forename: Agajanian Lumi
authors.initials: AL
authors.lastname: Tano
authors.forename: Laertes
authors.initials: L
authors.lastname: Thomaz Junior
authors.forename: Omar
authors.initials: O
authors.lastname: Fayad
mesh_terms: D000293:Adolescent; D000328:Adult; D021721:Balloon Occlusion; D001938:Brazil; D002404:Catheterization / Q000379:methods; D006785:Hospitals, University; D006801:Humans; D008099:Liver / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014950:Wounds, Penetrating / Q000628:therapy*; D055815:Young Adult