Abdominal Key

Fig. 5.1 Patient that sustained a close range shotgun blast with an AAST-OIS grade V hepatic injury and significant loss of the abdominal wall. Patient was rapidly transported to the…

Fig. 16.1 This figure shows a complex, stellate hepatic fracture within the interlobar plane between the gallbladder bed and inferior vena cava in a high-fidelity surgical simulator. Hepatic venous bleeding…

Fig. 10.1 CT scan of a 17-year-old boy with near traumatic liver resection. In this case, you may need to complete the liver resection on the initial operation Fig. 10.2…

Grade Injury description I Hematoma Subcapsular, <10 % surface area Laceration Capsular tear, <1 cm parenchymal depth II Hematoma Subcapsular, 10–50 % surface area; intraparenchymal, <10 cm diameter Laceration 1–3…

Reoperation mandatory  External drainage  End-tube hepatodochostomy or choledochostomy Reoperation not always necessary  T-tube or stent with limb beneath injury From Feliciano [9], Copyright Elsevier 1994 In patients with multiple intra-abdominal…

Fig. 3.1 The Mattox maneuver of left-sided visceral rotation to expose the proximal abdominal aorta Alternatively, the aorta may be approached through the lesser sac. The lesser omentum is widely…

Fig. 14.1 Admission CT scan of a 39-year-old man, after hepatorrhaphy, with an extensive injury to the right liver. Right hepatic artery clipping and tube cholecystostomy were previously done at…

Fig. 11.1 Omental pack. A graft of viable omentum is pulled through the penetrating tract in the liver Penrose pack. Described by Bluett et al. [4], it involves using a…

Fig. 4.1 Positive FAST showing fluid in the hepatorenal space In patients with penetrating trauma, FAST is less sensitive, and a negative FAST should not be used as the sole…

Fig. 7.1 Hepatic anatomy Under most circumstances, the right hepatic vein is the largest of the three and enters the superior surface of the vena cava on the right superior…