- Portal vein embolization in intrahepatic portal vein injury after blunt trauma: a case report
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Sung Hoon Cho, Sang Yub Lee, Jung Geun Cha, Jihoon Hong, Sangcjeol Lee, Kyoung Hoon Lim
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J Trauma Inj. 2022;35(Suppl 1):S31-S34. Published online May 19, 2022
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DOI: https://doi.org/10.20408/jti.2022.0013
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- Mortality from hepatic injury has declined over the last several decades for various reasons, including nonoperative management, such as angioembolization, in more than 80% of cases. Conversely, surgical treatment is preferred in intrahepatic portal vein injury due to several reasons. Here, we report a case that treatment of blunt traumatic liver injury accompanied by intrahepatic portal vein injury through portal vein embolization. A 29-year-old female patient was transferred to our trauma center for vehicular accident injuries. Contrast-enhanced abdominal computed tomography showed a massive hemoperitoneum and liver laceration (grade IV) with contrast extravasation suspected of the right portal vein branch but no other organ injury. Since vital signs were stable, we decided to perform nonsurgical radiologic intervention. Portography showed active bleeding of the posterior branch of the right portal vein. A pseudoaneurysm in the portal vein was embolized through percutaneous transhepatic portal vein puncture. On follow-up liver dynamic computed tomography performed 2 days after embolization, the posterior branch of the right portal vein was sufficiently embolized, and no liver parenchymal necrosis was observed. The patient was discharged without any complications 2 weeks later. This report suggests portal vein embolization as a good alternative treatment method for portal vein injury in patients with stable vital signs.
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Citations to this article as recorded by  - Portal vein embolization following arterial portography for the management of an active portal bleeding after blunt liver trauma in a cirrhotic patient
Romain L’Huillier, Bénédicte Cayot, Jean Turc, Laurent Milot
CVIR Endovascular.2024;[Epub] CrossRef
- Complete Transection of the Cystic Duct and Artery after Blunt Trauma: A Case Report
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Sung Hoon Cho, Kyoung Hoon Lim
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J Trauma Inj. 2021;34(4):294-298. Published online December 16, 2021
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DOI: https://doi.org/10.20408/jti.2021.0097
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Extrahepatic biliary tract and gallbladder injuries following blunt abdominal trauma are uncommon. Traumatic cystic duct transection is even rarer, which has frequently caused missed diagnosis and delayed treatment. An 18-year-old female patient with no past medical history was transferred to the Trauma Center of Kyungpook National University Hospital after falling from a height of approximately 20 meters. She became hemodynamically stable after initial resuscitation, and initial contrast-enhanced abdominal computed tomography (CT) showed right kidney traumatic infarction and multiple intrahepatic contusions with minimal fluid collection but no extravasation of the contrast. She was admitted to the intensive care unit. On the second day of hospitalization, her abdomen became distended, with follow-up CT showing a large collection of intra-abdominal fluid. Laparoscopic exploration was then performed, which revealed devascularization of the gallbladder with complete transection of the cystic duct and artery. Laparoscopic cholecystectomy was performed, as well as primary closure of the cystic duct orifice on the common bile duct using a 4-0 Prolene suture. After surgery, no clinical evidence of biliary leakage or common bile duct stricture was observed. -
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Citations to this article as recorded by - A Rare Complication of Percutaneous Transhepatic Gallbladder Drainage
Yang-Yuan Chen, Chih-Hsuan Chen, Yung-Fang Chen
Gastroenterology.2022; 163(5): e29. CrossRef
- Endovascular Salvage for Traumatic Midthoracic Aortic Rupture with Left Diaphragmatic Injury
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Shin-Ah Son, Tak-Hyuk Oh, Gun-Jik Kim, Deok Heon Lee, Kyoung Hoon Lim
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J Trauma Inj. 2018;31(2):66-71. Published online August 31, 2018
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DOI: https://doi.org/10.20408/jti.2018.31.2.66
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Patients with traumatic aortic rupture rarely reach the hospital alive. Even among those who arrive at the hospital alive, traumatic aortic rupture after high-speed motor vehicle accidents leads to a high in-hospital mortality rate and is associated with other major injuries. Here, we report a rare case of descending midthoracic aortic rupture with blunt diaphragmatic rupture. Successful management with emergency laparotomy after an immediate endovascular procedure resulted in a favorable prognosis in this case. -
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