Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

Hepatic Packing in Major Hepatic Trauma-Reply

Hepatic Packing in Major Hepatic Trauma-Reply Abstract In Reply.—Dr Ferguson's well-documented case demonstrates the value of packing a major hepatic and juxtahepatic venous injury in two clinical situations. The first indication was as a temporary expedient to permit transfer of the patient to a site more suitable for definitive treatment. We cited Blumgart and colleagues' report1 in this regard; this clearly is a useful expedient. The second was to permit correction of hypothermia that develops intraoperatively with concurrent coagulopathy. Both Feliciano and associates2 and Cogbill and associates3 have reported favorable results with packing of the hepatic wound after repair of major venous injury with ensuing coagulopathy. The survival rates of their patients were 34% and 59%, respectively. We have recently had a favorable experience in a similar circumstance. Both Feliciano et al2 and Cogbill et al3 and their respective associates also reported that packing was ineffective when undertaken as a desperation measure References 1. Blumgart LH, Drury JK, Wood CB. Hepatic resection for trauma, tumor and biliary obstruction . Br J Surg. 1979;66:762-769.Crossref 2. Feliciano DV, Mattox KL, Burch JM, Bitondo CG, Jordan GL. Packing for control of hepatic hemorrhage . J Trauma. 1986;26:738-743.Crossref 3. Cogbill TH, Moore EE, Jurkovich GJ, Feliciano DV, Morris JA, Mucha P. Severe hepatic trauma: a multi-center experience with 1335 liver injuries . J Trauma. 1988;28:1433-1438.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Hepatic Packing in Major Hepatic Trauma-Reply

Hepatic Packing in Major Hepatic Trauma-Reply

Abstract

Abstract In Reply.—Dr Ferguson's well-documented case demonstrates the value of packing a major hepatic and juxtahepatic venous injury in two clinical situations. The first indication was as a temporary expedient to permit transfer of the patient to a site more suitable for definitive treatment. We cited Blumgart and colleagues' report1 in this regard; this clearly is a useful expedient. The second was to permit correction of hypothermia that develops intraoperatively with...
Loading next page...
 
/lp/american-medical-association/hepatic-packing-in-major-hepatic-trauma-reply-XOJZ89VnGb
Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1989.01410040118031
Publisher site
See Article on Publisher Site

Abstract

Abstract In Reply.—Dr Ferguson's well-documented case demonstrates the value of packing a major hepatic and juxtahepatic venous injury in two clinical situations. The first indication was as a temporary expedient to permit transfer of the patient to a site more suitable for definitive treatment. We cited Blumgart and colleagues' report1 in this regard; this clearly is a useful expedient. The second was to permit correction of hypothermia that develops intraoperatively with concurrent coagulopathy. Both Feliciano and associates2 and Cogbill and associates3 have reported favorable results with packing of the hepatic wound after repair of major venous injury with ensuing coagulopathy. The survival rates of their patients were 34% and 59%, respectively. We have recently had a favorable experience in a similar circumstance. Both Feliciano et al2 and Cogbill et al3 and their respective associates also reported that packing was ineffective when undertaken as a desperation measure References 1. Blumgart LH, Drury JK, Wood CB. Hepatic resection for trauma, tumor and biliary obstruction . Br J Surg. 1979;66:762-769.Crossref 2. Feliciano DV, Mattox KL, Burch JM, Bitondo CG, Jordan GL. Packing for control of hepatic hemorrhage . J Trauma. 1986;26:738-743.Crossref 3. Cogbill TH, Moore EE, Jurkovich GJ, Feliciano DV, Morris JA, Mucha P. Severe hepatic trauma: a multi-center experience with 1335 liver injuries . J Trauma. 1988;28:1433-1438.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Apr 1, 1989

References