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Surgery Today

, Volume 36, Issue 6, pp 566–569 | Cite as

Immediate Postoperative Angiographic Embolization After Damage Control Surgery for Liver Injury: Report of a Case

  • Shigeki Kushimoto
  • Yuichi Koido
  • Kenichiro Omoto
  • Junichi Aiboshi
  • Futoshi Ogawa
  • Ryusuke Yoshida
  • Yasuhiro Yamamoto
Article

Abstract

A multimodality strategy, including damage control and angioembolization techniques, has been reported to reduce the mortality associated with surgery for complex blunt hepatic injuries. However, the indications for angiographic evaluation and embolization in patients who require surgery for hepatic injury remain unclear. We report a case of blunt hepatic injury requiring emergency laparotomy, which we treated by damage control surgery because of an inaccessible major venous injury and the fact that coagulopathy was stopping hemostasis. The decision to perform immediate postoperative angiography was based on the hemorrhagic response to Pringle's maneuver and its release after perihepatic packing during surgery. Hepatic angiography revealed extravasation from a branch of the middle hepatic artery, which was embolized successfully. Although the definitive indications for immediate postoperative angioembolization for hepatic injury have not been established, the hemorrhagic response to Pringle's maneuver and its release after perihepatic packing during damage control surgery is an indication for immediate postoperative angioembolization.

Key words

Liver injury Damage control Angiographic embolization 

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Copyright information

© Springer-Verlag Tokyo 2006

Authors and Affiliations

  • Shigeki Kushimoto
    • 1
  • Yuichi Koido
    • 1
  • Kenichiro Omoto
    • 1
  • Junichi Aiboshi
    • 1
  • Futoshi Ogawa
    • 1
  • Ryusuke Yoshida
    • 1
  • Yasuhiro Yamamoto
    • 1
  1. 1.Department of Emergency and Critical Care MedicineNippon Medical SchoolTokyoJapan

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