- Successful Endoscopic Treatment of Hepatic Duct Confluence Injury after Blunt Abdominal Trauma: Case Report
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Chan Ik Park, Sung Jin Park, Sang Bong Lee, Kwang Hee Yeo, Seon Uoo Choi, Seon Hee Kim, Jae Hun Kim, Dong Hoon Baek
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J Trauma Inj. 2016;29(3):93-97. Published online September 30, 2016
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DOI: https://doi.org/10.20408/jti.2016.29.3.93
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- Hepatic duct confluence injury, which is developed by blunt abdominal trauma, is rare. Conventionally, bile duct injury was treated by surgical intervention. In recent decades, however, there had been an increase in radiologic or endoscopic intervention to treat bile duct injury. In a hemodynamically stable patient, endoscopic intervention is considered as the first-line treatment for bile duct injury.
A 40 year-old man was transferred to the emergency department of OO trauma center after multiple blunt injuries. Contrast-enhanced abdominal computed tomography performed in another hospital showed a liver laceration with active arterial bleeding, fracture of the sacrum and left inferior pubic ramus, and intraperitoneal bladder rupture. The patient presented with hemorrhagic shock because of intra-peritoneal hemorrhage. After resuscitation, angiographic intervention was performed. After angiographic embolization of the liver laceration, emergency laparotomy was performed to repair the bladder injury. However, there was no evidence of bile duct injury on initial laparotomy. On post-trauma day (PTD) 4, the color of intra-abdominal drainage of the patient changed to a greenish hue; bile leakage was revealed on magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Bile leakage was detected near the hepatic duct confluence; therefore, a biliary stent was placed into the left hepatic duct. On PTD 37, contrast leakage was still detected but both hepatic ducts were delineated on the second ERCP. Stents were placed into the right and left hepatic ducts. On PTD 71, a third ERCP revealed no contrast leakage; therefore, all stents were removed after 2 weeks (PTD 85).
ERCP and biliary stenting could be effective treatment options for hemodynamically stable patients after blunt trauma.
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- Successful TAE after DCS for Active Arterial Bleeding from Blunt Hepatic Injury in a Child: A Case Report
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Chan Ik Park, Sang Bong Lee, Kwang Hee Yeo, Seungchan Lee, Sung Jin Park, Ho Hyun Kim, Jae Hun Kim, Chang Won Kim, Chan Yong Park
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J Trauma Inj. 2016;29(2):47-50. Published online June 30, 2016
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DOI: https://doi.org/10.20408/jti.2016.29.2.47
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- Transcatheter arterial embolization (TAE) for blunt hepatic injury in children is not common and is especially rare after damage control surgery (DCS). We report a successful TAE after DCS on a child for massive bleeding from the left hepatic artery due to a motor vehicle accident. The car (a sport utility vehicle) ran over the chest and abdomen of a 4-year-old boy. On arrival, initial vital signs were as follows: blood pressure, 70/40 mmHg; heart rate, 149/min; temperature, 36.7℃; respiratory rate, 38/min. After resuscitation, computed tomography was done, and a suspicious contrast leakage from a branch of the left hepatic artery and a spleen injury (grade V) were found. TAE was performed successfully after DCS for a liver injury.
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Citations
Citations to this article as recorded by  - Damage Control Surgery for Abdominal Compartment Syndrome Caused by Delayed Rupture of Hepatic Subcapsular Hematoma
Chan Yong Park, Kwang Hee Yeo, Ho Hyun Kim, Seon Hee Kim, Hyun Min Cho, Hoon Kwon, Chang Ho Jeon, Chang Won Kim, Seok Ran Yeom
Trauma Image and Procedure.2017; 2(1): 17. CrossRef
- External Iliac Artery Injury Caused by Abdominal Stab Wound: A Case Report
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Sang Bong Lee, Jae Hun Kim, Chan Ik Park, Kwang Hee Yeo
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J Trauma Inj. 2015;28(3):215-218. Published online September 30, 2015
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DOI: https://doi.org/10.20408/jti.2015.28.3.215
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- Traumatic iliac vessel injuries constitute approximately 25% of all abdominal vascular injuries. Hospital mortality has been reported at 25~60% and is a result of uncontrolled hemorrhage and hypovolemic shock caused by extensive blood loss. We report the case of a 25-year-old female patient who experienced an external iliac artery injury caused by abdominal minimal stab wound. Traumatic iliac vessel injuries are life-threatening complication of abdominal or pelvic injuries and prompt diagnosis and accurate treatment are important.
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- Penetrating Neck Trauma: A Case of Spinal Cord Injury by Embedded Scissor
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Seon Hee Kim, Sun Woo Choi, Sung Jin Park, Kwang Hee Yeo, Chang Wan Kim, Sang Bong Lee, Ho Hyun Kim, Chan Yong Park, Jae Hun Kim, Jung Joo Hwang, Hyun Min Cho
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J Trauma Inj. 2015;28(2):71-74. Published online June 30, 2015
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DOI: https://doi.org/10.20408/jti.2015.28.2.71
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- Penetrating neck trauma involving spinal cord injury is relatively uncommon, but can be life-threatening. We report a case of 59-year-old female who presented with hypotension after stab injury self-inflicted with a scissor to her neck. Although Open removal of the scissor and control of bleeding were successfully done, penetration of spinal cord resulted in a neurologic impairment.
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- Successful Angiographic Embolization of Superficial Circumflex Iliac Artery Rupture Caused by Blunt Abdominal Trauma: A Case Report
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Sang Bong Lee, Sung Jin Park, Kwang Hee Yeo, Ho Hyun Kim, Chan Yong Park, Jae Hun Kim, Chang Wan Kim, Seon Uoo Choi, Seon Hee Kim, Jung Joo Hwang, Hyun Min Cho
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J Trauma Inj. 2015;28(1):39-42. Published online March 30, 2015
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DOI: https://doi.org/10.20408/jti.2015.28.1.39
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- Lat. abdominal wall hematoma with active bleeding is very rare but need prompt bleeding control. We report successful treatment by angiographic embolization of superficial circumflex iliac artery rupture caused by blunt trauma. A 60-year-old woman presented painful, enlarging, lat. abdominal wall mass with ecchymosis caused by blunt abdominal trauma. Contrast leakage of superficial circumflex iliac a. within the lt. ext. oblique m. hematoma was confirmed by abdominal computed tomography. Angiographic embolization was performed successfully. Patient was discharged at 4th day after trauma without complication. Angiographic embolization is important treatment option of lat. abdominal wall hematoma with active bleeding replacing emergency surgery.
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