Semin intervent Radiol 2012; 29(03): 197-200
DOI: 10.1055/s-0032-1326929
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Transcatheter Treatment of Liver Laceration from Blunt Trauma

Andrew Hal Hardy
1   Department of Radiology
,
Ho Phan
2   Department of Surgery, UC Davis Medical Center, Sacramento, California
,
Pavan Khanna
1   Department of Radiology
,
Timothy Nolan
1   Department of Radiology
,
Paul Dong
1   Department of Radiology
› Author Affiliations
Further Information

Publication History

Publication Date:
16 October 2012 (online)

Abstract

Blunt hepatic trauma is a fairly common pathology seen in trauma centers. We describe a pediatric patient who suffered blunt hepatic trauma that was managed successfully with a combination of exploratory laparotomy and liver packing, followed by hepatic artery embolization by interventional radiology (IR) after he continued to have significant arterial extravasation. Also discussed are trends in overall blunt hepatic trauma management and the technique of IR management.

 
  • References

  • 1 Lee SK, Carrillo EH. Advances and changes in the management of liver injuries. Am Surg 2007; 73 (3) 201-206
  • 2 Monnin V, Sengel C, Thony F , et al. Place of arterial embolization in severe blunt hepatic trauma: a multidisciplinary approach. Cardiovasc Intervent Radiol 2008; 31 (5) 875-882
  • 3 Hagiwara A, Yukioka T, Ohta S , et al. Nonsurgical management of patients with blunt hepatic injury: efficacy of transcatheter arterial embolization. AJR Am J Roentgenol 1997; 169 (4) 1151-1156
  • 4 Tinkoff G, Esposito TJ, Reed J , et al. American Association for the Surgery of Trauma Organ Injury Scale I: spleen, liver, and kidney, validation based on the National Trauma Data Bank. J Am Coll Surg 2008; 207 (5) 646-655
  • 5 Kozar RA, Feliciano DV, Moore EE , et al. Western Trauma Association/critical decisions in trauma: operative management of adult blunt hepatic trauma. J Trauma 2011; 71 (1) 1-5
  • 6 Ramkumar K, Perera MT, Marudanayagam R , et al. A reaudit of specialist-managed liver trauma after establishment of regional referral and management guidelines. J Trauma 2010; 68 (1) 84-89
  • 7 Johnson JW, Gracias VH, Gupta R , et al. Hepatic angiography in patients undergoing damage control laparotomy. J Trauma 2002; 52 (6) 1102-1106
  • 8 Misselbeck TS, Teicher EJ, Cipolle MD , et al. Hepatic angioembolization in trauma patients: indications and complications. J Trauma 2009; 67 (4) 769-773
  • 9 Dabbs DN, Stein DM, Scalea TM. Major hepatic necrosis: a common complication after angioembolization for treatment of high-grade liver injuries. J Trauma 2009; 66 (3) 621-627 ; discussion 627–629
  • 10 Mohr AM, Lavery RF, Barone A , et al. Angiographic embolization for liver injuries: low mortality, high morbidity. J Trauma 2003; 55 (6) 1077-108 ; discussion 1081–1082
  • 11 Schwartz RA, Teitelbaum GP, Katz MD, Pentecost MJ. Effectiveness of transcatheter embolization in the control of hepatic vascular injuries. J Vasc Interv Radiol 1993; 4 (3) 359-365
  • 12 Kandarpa K, Machan L , eds. Handbook of Interventional Radiologic Procedures. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2011
  • 13 Burke CT, Dixon R, Mauro M , et al , eds. High-Yield Imaging: Interventional. Philadelphia, PA: Elsevier; 2010: 193-195