2017 Volume 31 Issue 1 Pages 13-16
A 35-year-old woman was injured while riding her bicycle and presented to our department. We performed perihepatic packing based on a diagnosis of hemorrhagic shock with hepatic injury type III b, and performed interventional radiology after surgery. There was extravasation from the right hepatic artery (RHA), which branched from the superior mesenteric artery. We attempted transcatheter arterial embolization (TAE), but it was difficult because the branching angle had markedly changed with abdominal compartment syndrome. We therefore performed RHA ligation with laparotomy and achieved successful hemostasis. The patient was discharged without complications, in contrast to the predicted survival rate of 27.6%. Right hepatic artery ligation is considered an effective surgical procedure for damage control in cases of uncontrolled hemorrhage when TAE is impossible.
