medigraphic.com
ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2019, Number 1

<< Back Next >>

Cir Gen 2019; 41 (1)

Management of perforating liver injury with Bakri balloon. Presentation of a case

Vargas-Ávila AL, Campos-Badillo JA, Pérez-Soto A, Castillejos-Márquez YS, Vargas-Flores J, Ávila-Rivera JL

Language: Spanish
References: 18
Page: 47-53
PDF size: 302.26 Kb.


ABSTRACT

Introduction: Trauma injuries are the leading cause of death in Mexico in patients from one to 44 years old. In abdominal trauma, the liver is the organ most frequently affected because of its location and size. Of the patients admitted in trauma centers, 5% have liver injuries. Complex liver injuries account for 10-30% of them, with a high mortality reported from 40-80%. The delay in the recognition of intraabdominal injuries can cause early death due to hemorrhage, or belatedly because of visceral injuries. The main cause of death in liver injuries is massive hemorrhage, which is associated with a mortality rate of 50-54% in the early hours of admission, reaching 80% in patients undergoing surgery. The Bakri balloon is a medical device made with silicon was described in 1992 by Younes Bakri, an Ob-Gyn. It was designed for intrauterine tamponade, and its mechanism of action is based on the increase of intraluminal pressure on the uterine wall, and consequently, on the uterine vasculature. Case-report: We report the case of a 39-year-old male patient who came to the emergency room after suffering a stab wound in the right hemithorax. He had hypovolemic shock, so after intensive reanimation was sent to surgery, where a transfixed grade V liver injury was found in the right lobe, was managed successfully with a Bakri balloon was set into the tunnel of the liver injury. The patient was discharged on the eighth day without postsurgical complications. Conclusion: The use of a Bakri balloon, not previously described for handling this type of injury, is an excellent alternative with good outcome.


REFERENCES

  1. Noyola-Villalobos HF, Loera-Torres MA, Jiménez-Chavarría E, Núñez-Cantú O, García-Núñez LM, Arcaute-Velázquez FF. Tratamiento no operatorio de las lesiones hepáticas por trauma no penetrante: artículo de revisión. Cirugía y Cirujanos. 2016; 84: 263-266.

  2. Silvio-Estaba L, Madrazo-González Z, Ramos-Rubio E. Actualización del tratamiento de los traumatismos hepáticos. Cir Esp. 2008; 83: 227-234.

  3. González-Castro A, Suberviola-Cañas B, Holanda-Peña MS, Ots E, Domínguez-Artiga MJ, Ballesteros MA. Traumatismo hepático. Descripción de una cohorte y valoración de opciones terapéuticas. Cir Esp. 2007; 81: 78-81.

  4. Polanco P, Leon S, Pineda J, Puyana JC, Ochoa JB, Alarcon L, et al. Hepatic resection in the management of complex injury to the liver. J Trauma. 2008; 65: 1264-1269; discussion 1269-1270.

  5. Asensio JA, Demetriades D, Chahwan S, Gomez H, Hanpeter D, Velmahos G, et al. Approach to the management of complex hepatic injuries. J Trauma. 2000; 48: 66-69.

  6. Advanced Trauma Life Support. Manual del curso para estudiantes. Capítulo 5. 9.a ed. Chicago, IL: American College of Surgeons; 2012. pp. 122-140.

  7. Coccolini F, Montori G, Catena F, Di Saverio S, Biffl W, Moore EE, et al. Moore. Liver trauma: WSES position paper. World J Emerg Surg. 2015; 10: 39.

  8. Doklestić K, Stefanović B, Gregorić P, Ivančević N, Lončar Z, Jovanović B, et al. Surgical management of AAST grades III-V hepatic trauma by damage control surgery with perihepatic packing and definitive hepatic repair–single centre experience. World J Emerg Surg. 2015; 10: 34.

  9. Stassen NA, Bhullar I, Cheng JD, Crandall M, Friese R, Guillamondegui O, et al. Nonoperative management of blunt hepatic injury: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012; 73: S288-S293.

  10. Demetriades D, Hadjizacharia P, Constantinou C, Brown C, Inaba K, Rhee P, et al. Selective nonoperative management of penetrating abdominal solid organ injuries. Ann Surg. 2006; 244: 620-628.

  11. Ordoñez CA, Parra MW, Salamea JC, Puyana JC, Millán M, Badiel M, et al. A comprehensive five-step surgical management approach to penetrating liver injuries that require complex repair. J Trauma Acute Care Surg. 2013; 75: 207-211.

  12. Bala M, Gazalla SA, Faroja M, Bloom AI, Zamir G, Rivkind AI, et al. Complications of high grade liver injuries: management and outcome with focus on bile leaks. Scand J Trauma Resusc Emerg Med. 2012; 20: 20.

  13. Piper GL, Peitzman AB. Current management of hepatic trauma. Surg Clin North Am. 2010; 90: 775-785.

  14. Ozdogan M, Ozdogan H. Balloon tamponade with Sengstaken-Blakemore tube for penetrating liver injury: case report. J Trauma. 2006; 60: 1122-1123.

  15. Beitner MM, Suh N, Dowling R, Miller JA. Penetrating liver injury managed with a combination of balloon tamponade and venous stenting. A case report and literature review. Injury. 2012; 43: 119-122.

  16. Ball CG, Wyrzykowski AD, Nicholas JM, Rozycki GS, Feliciano DV. A decade’s experience with balloon catheter tamponade for the emergency control of hemorrhage. J Trauma. 2011; 70: 330-333.

  17. Ortega-Castillo VMJ, Espino SS, Herrerías-Canedo T. Control de la hemorragia obstétrica con balón de Bakri. Ginecol Obstet Mex. 2013; 81: 435-439.

  18. Demetriades D. Balloon tamponade for bleeding control in penetrating liver injuries. J Trauma. 1998; 44: 538-539.




2020     |     www.medigraphic.com