Skip to main content
SpringerLink
Log in
Book cover

Operative Techniques for Severe Liver Injury pp 35–40Cite as

Massive Hepatic Hemorrhage: Identification

  • Chapter
  • First Online:

  • 1499 Accesses

Abstract

Quick recognition of the bleeding patient and rapid deployment of the trauma team are essential. Focused sonography in trauma should be used in all cases expeditiously. Unstable patients with suspicion of intra-abdominal hemorrhage should have immediate laparotomy. Liver bleeding is readily apparent and most can be controlled using liver compression, packing, and local hemostatic maneuvers, with or without hepatoduodenal ligament occlusion. Bleeding not responsive to these measures usually signifies juxtahepatic venous hemorrhage and will usually require mobilization of the liver for exposure and hemostasis.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   139.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Eastridge BJ, Salinas J, McManus JG, Blackburn L, Bugler EM, Cooke WH, et al. Hypotension begins at 110 mm Hg: redefining “hypotension” with data. J Trauma. 2007;63(2):291–9.

    Article  PubMed  Google Scholar 

  2. Quinn AC, Sinert R. What is the utility of the Focused Assessment with Sonography in Trauma (FAST) exam in penetrating torso trauma? Injury. 2011;42(5):482–7.

    Article  PubMed  Google Scholar 

  3. Bickell WH, Wall Jr MJ, Pepe PE, Martin RR, Ginger VF, Allen MK, et al. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med. 1994;27(17):1105–9.

    Article  Google Scholar 

  4. Seamon MJ, Fisher CA, Gaughan JP, Kulp H, Dempsey DT, Goldberg AJ. Emergency department thoracotomy: survival of the least expected. World J Surg. 2008;32:604–12.

    Article  PubMed  Google Scholar 

  5. Moore EE, Knudson MM, Burlew CC, Inaba K, Dicker RA, Biffl WL, et al. Defining the limits of resuscitative emergency department thoracotomy: a contemporary Western Trauma Association perspective. J Trauma. 2011;70(2):334–9.

    Article  PubMed  Google Scholar 

  6. McKenney KL, McKenney MG, Cohn SM, Compton R, Nunez DB, Dolich M, et al. Hemoperitoneum score helps determine need for therapeutic laparotomy. J Trauma. 2001;50(4):650–4.

    Article  PubMed  CAS  Google Scholar 

  7. Matsumoto H, Ohshiro K. Ultrasound in abdominal trauma. In: Machi J, Sigel B, editors. Ultrasound for surgeons. New York/Tokyo: IGAKU-SHOIN Medical Publishers; 1997. p. 72–9.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Reading Hospital, Sixth Ave and Spruce Street, West Reading, PA, 19611, USA

    Adrian W. Ong MD

  2. Department of Surgery, Reading Hospital, Sixth Ave & Spruce St, West Reading, PA, 19611, USA

    Vicente Cortes MD, FACS

  3. Division of Trauma/Critical Care, Department of Surgery, Conemaugh Memorial Hospital, 1086 Franklin Street, Johnstown, PA, 15905, USA

    Aurelio Rodriguez MD

Authors
  1. Adrian W. Ong MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vicente Cortes MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aurelio Rodriguez MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Adrian W. Ong MD .

Editor information

Editors and Affiliations

  1. Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA

    Rao R. Ivatury

Video Captions

Right hepatic lobe rotation (MP4 42120 kb)

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

Pringle maneuver (MP4 14015 kb)

Liver suture (MP4 39685 kb)

Hepatic vascular exclusion (MP4 99239 kb)

Omental pack (MP4 32585 kb)

Digital compression (MP4 16750 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this chapter

Cite this chapter

Ong, A.W., Cortes, V., Rodriguez, A. (2015). Massive Hepatic Hemorrhage: Identification. In: Ivatury, R. (eds) Operative Techniques for Severe Liver Injury. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1200-1_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-1200-1_4

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1199-8

  • Online ISBN: 978-1-4939-1200-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation