Vascular Injuries of Porta Hepatis
Vascular injuries of the porta hepatis possess the unfavorable combination of being both rare and life threatening. Reported experience from different institutions is similar with respect to the fact that they comprise small case series over relatively long intervals of time, reflecting the infrequency with which one encounters these injuries. Associated mortality rates have been reported between 40 and 70 %, and death is most commonly a result of exsanguination. A potentially lethal injury that is seldom encountered should give the trauma surgeon pause, and the importance of having a preestablished management strategy in mind must be emphasized. In this chapter, we will provide an overview of the relevant anatomy and physiology, techniques for hemorrhage control and operative exposure, and a strategy for the definitive management of portal vein and hepatic artery injuries.
KeywordsPortal Vein Common Bile Duct Hepatic Artery Hepatoduodenal Ligament Porta Hepatis
Pringle maneuver (MP4 14015 kb)
Finger fracture of the liver (MP4 22289 kb)
- 6.Child CG, Milnes RF, Holswade GR, Gore AL. Sudden and complete occlusion of the portal vein in the Macaca mulatta monkey. Ann Surg. 1950;68:155–75.Google Scholar
- 8.Ivatury RR. Basic operative techniques in trauma and emergency surgery. In: Britt LD, Peitzman A, Barie P, Jurkovich G, editors. Acute care surgery. Philadelphia: Lippincott Williams & Wilkins; 2012.Google Scholar