Advertisement

World Journal of Surgery

, Volume 43, Issue 2, pp 486–489 | Cite as

Intrahepatic Balloon Tamponade for Penetrating Liver Injury: Rarely Needed but Highly Effective

  • Lisa M. Kodadek
  • David T. Efron
  • Elliott R. HautEmail author
Innovative Surgical Techniques Around the World

Abstract

Background

Severe penetrating liver injuries are associated with high rates of morbidity and mortality. The objective of this study was to demonstrate the 15-year experience of a Level 1 US trauma center with use of intrahepatic balloon tamponade for penetrating liver injuries in adult patients.

Methods

Operative notes were used to identify cases employing intrahepatic balloon tamponade. Charts were reviewed for patient characteristics, injury characteristics, morbidity, and in-hospital mortality.

Results

Of the 4961 penetrating trauma patients admitted during the study period, 279 (5.6%) had liver injury and underwent exploratory laparotomy. Intrahepatic balloon tamponade was attempted in nine patients (3.2%). Two of the nine patients (22%) were in cardiac arrest at time of balloon placement and died during the index operation; both had retrohepatic IVC injury combined with cardiopulmonary injury. In patients who reached the operating room alive and had spontaneous circulation at the time of balloon placement, utilization of this technique was associated with 100% survival.

Conclusion

Although rarely needed, trauma surgeons must be prepared to use intrahepatic balloon tamponade as one surgical technique to control major hepatic injuries.

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Ball CG, Wyrzykowski AD, Nicholas JM et al (2011) A decade’s experience with balloon catheter tamponade for the emergency control of hemorrhage. J Trauma 70:330–333CrossRefGoogle Scholar
  2. 2.
    Fraga GP, Zago TM, Pereira BM et al (2012) Use of Sengstaken-Blakemore intrahepatic balloon: an alternative for liver-penetrating injuries. World J Surg 36(9):2119–2124.  https://doi.org/10.1007/s00268-012-1625-x CrossRefGoogle Scholar
  3. 3.
    Poggetti RS, Moore EE, Moore FA et al (1992) Balloon tamponade for bilobar transfixing hepatic gunshot wounds. J Trauma 33(5):694–697CrossRefGoogle Scholar
  4. 4.
    Kodadek LM (2016) Saving life and limb: multidisciplinary management of complex penetrating trauma. J Am Coll Surg 222(2):e11–e12CrossRefGoogle Scholar
  5. 5.
    Smaniotto B, Bahten LC, Nogueira Filho DC et al (2009) Hepatic trauma: analysis of the treatment with intrahepatic balloon in a university hospital of Curitiba. Rev Col Bras Cir 36(3):217–222CrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Lisa M. Kodadek
    • 1
  • David T. Efron
    • 2
  • Elliott R. Haut
    • 2
    Email author
  1. 1.Department of SurgeryVanderbilt University School of MedicineNashvilleUSA
  2. 2.Department of SurgeryJohns Hopkins University School of MedicineBaltimoreUSA

Personalised recommendations