title: Traumatic laceration of the portal vein.
abstract: Despite its relatively protected position, the liver is the most frequently injured solid intra-abdominal organ. 1 Most liver injuries can be managed conservatively, but about 5% to 10% require urgent laparotomy, usually when the mechanism of injury involves a vehicle accident and hemodynamic instability persists, in spite of 40 mL/kg of blood transfusion. 2 , 3 In particular, grades IV and V liver injuries may pose a challenge to the surgeon trying to control hemorrhage, the leading cause of mortality. 4 Traumatic injuries to the portal vein are rare but devastating. The mortality rate for portal vein injury ranges from 50% to 70%. A recent study of portal triad injuries has highighted the higher mortality rates associated with combination injuries involving multiple portal triad components, especially those that include portal vein injury. 5 This case study describes a unique case of relatively minor trauma in a child resulting in portal triad injury, sudden demise, and surgical repair.
authors.affiliation: *Emergency Medicine Department,Kars State Hospital,Kars,Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kama
authors.affiliation: †Department of Pediatric Surgery,Kars State Hospital,Kars,Turkey.
authors.forename: Savas
authors.initials: S
authors.lastname: Coskun
authors.affiliation: ‡Department of General Surgery,Kars State Hospital,Kars,Turkey.
authors.forename: Melih
authors.initials: M
authors.lastname: Yuksel
authors.affiliation: §Emergency Medicine Department,Balıkesir School of Medicine,Balıkesir,Turkey.
authors.forename: Ali Cihat
authors.initials: AC
authors.lastname: Yildirim
authors.affiliation: ¶Emergency Medicine Department,Kafkas University School of Medicine,Kars,Turkey.
authors.forename: Elnare
authors.initials: E
authors.lastname: Gunal
authors.affiliation: ¶Emergency Medicine Department,Kafkas University School of Medicine,Kars,Turkey.
authors.forename: Gulsen
authors.initials: G
authors.lastname: Cıgsar
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging* / Q000601:surgery; D001642:Bicycling / Q000293:injuries*; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D001803:Blood Transfusion / Q000379:methods; D002648:Child; D004636:Emergency Service, Hospital; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D022125:Lacerations / Q000000981:diagnostic imaging / Q000601:surgery; D007813:Laparotomy / Q000379:methods; D008099:Liver / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000601:surgery; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014656:Vascular Surgical Procedures / Q000379:methods