title: Penetrating liver injury managed with a combination of balloon tamponade and venous stenting. A case report and literature review.
abstract: AAST-OIS grade V complex hepatic injuries are often fatal as a result of exsanguination. We report a patient presenting in extremis with a penetrating injury to the right kidney, liver, middle hepatic vein, diaphragm, and lung. A combination of intrahepatic balloon tamponade and hepatic venous stenting was used to control exsanguinating haemorrhage, the first time this combination has been reported. Rapid assessment and treatment and a team approach, together with the innovative application of haemostatic techniques, allowed a multidisciplinary team to salvage this patient.
authors.affiliation: Department of Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Beitner
authors.forename: Nancy
authors.initials: N
authors.lastname: Suh
authors.forename: Richard
authors.initials: R
authors.lastname: Dowling
authors.forename: Julie A
authors.initials: JA
authors.lastname: Miller
mesh_terms: D000328:Adult; D021721:Balloon Occlusion; D003964:Diaphragm / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D006503:Hepatic Veins / Q000293:injuries / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007668:Kidney / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D008099:Liver / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D015607:Stents; D016896:Treatment Outcome; D014951:Wounds, Stab / Q000503:physiopathology / Q000628:therapy*