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Use of Sengstaken-Blakemore Intrahepatic Balloon: An Alternative for Liver-Penetrating Injuries

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Abstract

Background

Severe lesions in the liver are associated with a high mortality rate. Alternative surgical techniques such as the use of an intrahepatic balloon may be effective and reduce mortality in severe hepatic lesions. This study aimed to demonstrate the experience of a university hospital in the use of the Sengstaken-Blakemore balloon in patients with transfixing penetrating hepatic injury as an alternative way to treat these challenging injuries.

Methods

A retrospective study based on the trauma registry of a university hospital was performed. All patients admitted with hepatic penetrating injuries and treated with the Sengstaken-Blakemore balloon within the period 1990–2010 were reviewed.

Results

Forty-six patients with transfixing hepatic injuries were treated with the Sengstaken-Blakemore balloon in the study period. The most frequent cause of injury was gunshot wound (87 % of the patients). The mean trauma scores on admission were Revised Trauma Score (RTS) = 7.12 ± 1.46, Injury Severity Score (ISS) = 22.4 ± 9.7, and Abdominal Trauma Index (ATI) = 19.5 ± 11. According to the severity of the hepatic trauma, 71.8 % of patients had grade III, 23.9 % grade IV, and 4.3 % grade V injuries. Associated abdominal injuries were found in 89.1 % of the patients. The most frequent liver-related complications were hepatic abscess postoperative bleeding (8.6 %), biliary fistula (8.6 %), (4.3 %), and biliary peritonitis (2.1 %). Surgical reintervention was necessary in 14 patients (31.1 %). From those 14, only 3 had the balloon removed. The overall morbidity and mortality rates were 56.5 % and 23.9 % (11 patients), respectively.

Conclusion

The knowledge of alternative surgical techniques is essential in improving survival in patients with severe penetrating hepatic injuries. The use of intrahepatic balloon is a viable surgical strategy.

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The authors have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Division of Trauma Surgery, Department of Surgery, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil

    Gustavo Pereira Fraga, Bruno Monteiro Pereira, Thiago Rodrigues Araujo Calderan & Henrique Jose Virgili Silveira

  2. Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil

    Thiago Messias Zago

  3. Rua Alexander Fleming, 181, Cidade Universitaria Prof. Zeferino Vaz, Campinas, SP, 13.083-970, Brazil

    Gustavo Pereira Fraga

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  1. Gustavo Pereira Fraga
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  2. Thiago Messias Zago
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  3. Bruno Monteiro Pereira
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  4. Thiago Rodrigues Araujo Calderan
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  5. Henrique Jose Virgili Silveira
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Correspondence to Thiago Messias Zago.

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Fraga, G.P., Zago, T.M., Pereira, B.M. et al. Use of Sengstaken-Blakemore Intrahepatic Balloon: An Alternative for Liver-Penetrating Injuries. World J Surg 36, 2119–2124 (2012). https://doi.org/10.1007/s00268-012-1625-x

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  • DOI: https://doi.org/10.1007/s00268-012-1625-x

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