A CASE OF RIGHT HEPATECTOMY AND RIGHT RENAL ARTERY RECONSTRUCTION FOR SEVERE HEPATIC INJURY AND RIGHT RENAL ARTERY INJURY

Abstract

　　Damage control surgery is generally the treatment strategy of choice for patients at high risk of coagulopathy and hypothermia due to severe liver injury (SLI) and massive hemoperitoneum (MH). In this context, abbreviated surgery is frequently employed as the primary surgical procedure for patients with comorbid injuries. We report a case of SLI and renal artery injury (RAI) that was successfully treated with primary definitive repair. The patient, an 18 y.o. male, was injured in a traffic accident. CE-CT revealed SLI with MH and RAI. He underwent urgent laparotomy. First the hemodynamics were stabilized by massive transfusion and bleeding control. Then, we completed right hepatectomy and reconstruction of the artery. Even in cases of abdominal injury with MH, precise diagnosis and identification of the source of bleeding are important, as they warrant early hemodynamic stabilization and allow the prolonged operative time necessary for primary definite repair.