Modified Technique of Mesh Hepatorrhaphy for Management of Juxtahepatic Venous Injury in a Case of Blunt Liver Trauma: A Case Report

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
Jude Rodrigues, Jean-Louis de Menezes

Abstract

The liver is the most frequently injured organ in cases of blunt abdominal trauma. Injuries to the caudate lobe are rarely isolated and usually associated with retrohepatic caval injury or hepatic vein injury. The management of the associated vascular injuries is usually difficult owing to the short courses of the hepatic veins and the difficulty in obtaining proximal and distal control of the suprarenal and suprahepatic inferior vena cava - hence the frequency of perihepatic packing in the management of caudate lobe and hepatic venous injuries. We present here a rare case of the failure of perihepatic packing to effectively control hemorrhage from blunt injury to the caudate lobe and retrohepatic vena cava. A case of blunt abdominal trauma with injury to the caudate lobe and retrohepatic venous injury was initially managed with perihepatic packing. The patient developed hemorrhage 48 h after pack removal, which was then successfully managed with mesh hepatorrhaphy of the caudate lobe.

References

Jan 1, 1992·The British Journal of Surgery·J E KrigeJ Terblanche
Jan 1, 1990·HPB Surgery : a World Journal of Hepatic, Pancreatic and Biliary Surgery·J E KrigeJ Terblanche
Jun 1, 1995·The Journal of Trauma·R J ChenM F Chen

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