Massive Liver Trauma—Multidisciplinary Approach and Minimal Invasive Surgery can Salvage Patients

Management of massive liver trauma (grades IV–VI) is associated with high morbidity and mortality. It can pose serious challenges to treating physician and requires multimodality interventions. For a successful outcome, timing of intervention is crucial. We report a case of grade V hepatic injury tr...

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Bibliographic Details
Published in:Indian journal of surgery 2013-06, Vol.75 (Suppl 1), p.449-452
Main Authors: Thapar, Pinky M., Ghawat, Ravindra M., Dalvi, Abhay N., Rokade, Muktachand L., Philip, Roji M., Warawdekar, Gireesh M., Bapat, Mukta R.
Format: Article
Language:English
Subjects:
Cardiac Surgery
Case Report
Health aspects
Liver
Medicine
Medicine & Public Health
Mortality
Neurosurgery
Pediatric Surgery
Plastic Surgery
Surgery
Thoracic Surgery
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Summary:Management of massive liver trauma (grades IV–VI) is associated with high morbidity and mortality. It can pose serious challenges to treating physician and requires multimodality interventions. For a successful outcome, timing of intervention is crucial. We report a case of grade V hepatic injury treated successfully with angioembolization, laparoscopic lavage, and endoscopic stenting during a time period from admission to discharge on the 24th day. Angioembolization was performed at admission after resuscitation as CT scan showed active extravasation in the arterial phase. Laparoscopic lavage and drainage was performed on the fifth day as abdominal inflammatory response failed to respond to medical management. There was biliary component of abdominal fluid noticed during laparoscopy, which manifested by postoperative localized biliary fistula; hence endoscopic stenting of the bile duct was performed on the seventh day. The patient recovered well with timely minimal invasive approach and was fine at 1 year follow-up.
ISSN:0972-2068
0973-9793
DOI:10.1007/s12262-012-0781-4