Massive Hepatic Hemorrhage: Initial Steps in Hemostasis

  • Juan A. AsensioEmail author
  • Juan Manuel Verde
  • Patrizio Petrone
  • Alejandro J. Pérez-Alonso
  • Corrado Marini
  • Anthony Policastro


Despite the continued advances in the areas of Trauma Surgery and Surgical Critical Care, the mortality of complex hepatic injuries remains extremely high. Similarly, their surgical management poses a formidable challenge to even the most experienced trauma surgeons. Uncontrolled hemorrhage leading to exsanguination is the leading cause of hepatic mortality, accounting for over 50 % of hepatic injury induced mortality.


Inferior Vena Cava Trauma Surgeon Pringle Maneuver Argon Beam Coagulator Initial Hemostasis 
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Supplementary material

Video 2

Right hepatic lobe rotation (MP4 42120 kb)

Video 3

Right hepatic lobe rotation (3-D animation) (MP4 33079 kb)

Video 4

Left hepatic lobe rotation (MP4 53192 kb)

Video 5

Left hepatic lobe rotation (3-D animation) (MP4 30377 kb)

Video 6

Pringle maneuver (MP4 14015 kb)

Video 8

Finger fracture of the liver (MP4 22289 kb)


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Juan A. Asensio
    • 1
    • 2
    Email author
  • Juan Manuel Verde
    • 3
  • Patrizio Petrone
    • 4
  • Alejandro J. Pérez-Alonso
    • 3
  • Corrado Marini
    • 5
  • Anthony Policastro
    • 6
  1. 1.Department of SurgeryNew York Medical CollegeValhallaUSA
  2. 2.Division of Trauma Surgery and Acute Care SurgeryJoel A. Halpern Trauma Center, International Medicine Institute, Research Institute, Westchester Medical CenterValhallaUSA
  3. 3.Westchester Medical CenterValhallaUSA
  4. 4.New York Medical College/Westchester Medical CenterValhallaUSA
  5. 5.New York Medical College/Westchester Medical CenterValhallaUSA
  6. 6.Westchester Medical CenterValhallaUSA

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