A blunt complex abdominal trauma: Total hepatectomy and liver transplantation

D. Chiumello, S. Gatti, M. L. Caspani, M. Savioli, Rainero L. Fassati, L. Gattinoni

Research output: Contribution to journalArticle

Abstract

A victim of a motor accident was referred to the Emergency Department. He was unconscious, breathing was rapid and shallow, and had a mean arterial pressure of 60 mmHg with a distended abdomen. A peritoneal lavage was positive for blood. An immediate laparotomy showed a massive hepatic injury with bilobar disruptions. After an unsuccessful hepatorrhaphy an extensive perhepatic gauze packing was done. During the operation the patient was massively transfused and high doses of dopamine were used. At the end a relative stability was reached, but a few hours later, due to the high risk of sepsis and abdominal compartment syndrome, a second laparotomy was performed. Despite efforts to reach a good hemostasis, it was decided to perform a total hepatectomy and portocaval shunt. The patient was put on the waiting list for a compatible liver. After 36 h in this anhepatic state, the patient received the new graft. The graft showed immediate recovery. In cases of severe and complex liver trauma, performing a total hepatectomy followed by liver transplantation is justified.

Original languageEnglish
Pages (from-to)89-91
Number of pages3
JournalIntensive Care Medicine
Volume28
Issue number1
DOIs
Publication statusPublished - 2002

Keywords

  • Abdominal trauma
  • Blunt hepatic trauma
  • Liver transplantation
  • Total hepatectomy

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Chiumello, D., Gatti, S., Caspani, M. L., Savioli, M., Fassati, R. L., & Gattinoni, L. (2002). A blunt complex abdominal trauma: Total hepatectomy and liver transplantation. Intensive Care Medicine, 28(1), 89-91. https://doi.org/10.1007/s00134-001-1162-9