Iatrogenic liver trauma managed with mesh-wrapping and ligation of portal vein branch: A case report

Dellaportas, Dionysios; Nastos, Constantinos; Psychogiou, V.; Tympa, Aliki; Τsaroucha, Athanasia; Kontis, John; Smyrniotis, Vassilios

doi:10.1016/j.ijscr.2011.08.005

Cited by 8 publications

(9 citation statements)

References 7 publications

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“…The advantage however of liver wrapping is that there is no need for reoperation to remove the mesh, the hazard of re-bleeding is diminished because the mesh is left in place, and the incidence of septic complications is low [17] . Two important technical steps that have been previously described and are re-emphasized in this case report is the need to wrap the mesh under enough tension to create a temponade effect and to secure the mesh on two anchoring points [15] . In this case, the mesh was sutured to the diaphragmatic crus as well as to the falciform ligament.…”

Section: Discussionmentioning

confidence: 89%

“…It was first introduced by Buntain and Lynn for the control of splenic hemorrhage [13] . The use of mesh has also been described during liver transplant following graft injury in pediatric liver trauma [10] , [14] as well as in adult liver trauma with or without gauze packing [15] , [16] . However the literature remains scarce.…”

Section: Discussionmentioning

confidence: 99%

“…An alternative to liver packing would be the resection of the affected segment, however this should be assessed based on the extent of the injury as well as on the hemodynamic stability of the patient [15] who, in majority are hemodynamically compromised. The advantage however of liver wrapping is that there is no need for reoperation to remove the mesh, the hazard of re-bleeding is diminished because the mesh is left in place, and the incidence of septic complications is low [17] .…”

Section: Discussionmentioning

confidence: 99%

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Mesh-wrapping for the treatment of fractured liver—A case report

Chamseddine

Khalifeh

Khoury

et al. 2016

International Journal of Surgery Case Reports

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HighlightsLiver injuries can be managed conservatively but operative management is needed once patients are hemodynamically unstable.Peri-hepatic packing is considered a life-saving procedure in complex liver injuries; however, it is not very efficient in case of significant liver injury.Intra-operative liver bed bleeding was initially controlled by high beam cauterization, surgicel and some Argon beam.The liver was later wrapped with a polyester mesh with collagen barrier; the mesh was wrapped completely over the right lobe of the liver and was sutured to itself and to the diaphragm surface as well as to the falciform ligament.Using an absorbable mesh on a traumatized and fragmented liver appears to be a safe and effective approach to high grade liver injury.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Mesh-wrapping for the treatment of fractured liver—A case report

Chamseddine

Khalifeh

Khoury

et al. 2016

International Journal of Surgery Case Reports

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“…In general, Child-Pugh score (>7) or model of end liver disease (MELD) score (>11) for patients with liver trauma or iatrogenic injuries are climbed, the therapy with transcatheter arterial embolization (TAE) may be safer compared to surgery [3]. But if you have no way to stop bleeding, mesh-wrapping [4] or gauze-packing during surgery is a possible remedy to stop intrahepatic ongoing bleeding.…”

Section: Letter To the Editormentioning

confidence: 99%

Assessment of occasional diathermy burn of central vessel triggered by hepatic tumor radiofrequency

Zhong¹,

Li²

2018

biomedicalresearch

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“…The mesh is resorbable and therefore reoperation for removal is not necessary. Furthermore, the resulting product of mesh hydrolysis has a bacteriostatic effect, minimizing the risk of infection [60].…”

Section: Mesh Wrappingmentioning

confidence: 99%

Management of Hepatobiliary Trauma

Jagad¹,

Thorat²,

Lee³

2013

Hepatic Surgery

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Additional information is available at the end of the chapter http://dx.doi.org/10.5772/52107. Introduction:The liver is the most commonly injured solid abdominal organ, despite its relative protected location [ , ]. Treatment of traumatic liver injuries is based on patient physiology, mechanism and degree of injury, associated abdominal and extra-abdominal injuries and local expertise. Non-operative management has evolved into the treatment of choice for most patients with blunt liver injuries who are hemodynamically stable and success rates for nonoperative management commonly are greater than %. With the sweeping shift towards the non-operative management, most hepatic injuries can be treated conservatively [ , , ].More recently several authors have highlighted an excessive use of non-operative management NOM , which for some high grade liver injuries is pushed far beyond the reasonable limits, carrying increased morbidity at short and long term, such as bilomas, biliary fistula, early or late haemorrhage, false aneurysm, arterio-venous fistulae, haemobilia, liver abscess, and liver necrosis [ ]. Incidence of complications attributed to NOM increases in concert with the grade of injury. In a series of patients with liver injury grades III-V treated non-operatively, those with grade III had a complication rate of %, grade IV %, and grade V % [ ].

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Iatrogenic liver trauma managed with mesh-wrapping and ligation of portal vein branch: A case report

Abstract: Mesh wrapping of the fragmented liver with absorbable mesh constitutes a safe and effective method, in treating grade IV and V liver injuries, especially when combined with ipsilateral ligation of the bleeding vessel.

Cited by 8 publications

References 7 publications

Mesh-wrapping for the treatment of fractured liver—A case report

Mesh-wrapping for the treatment of fractured liver—A case report

Assessment of occasional diathermy burn of central vessel triggered by hepatic tumor radiofrequency

Management of Hepatobiliary Trauma

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