Severe liver trauma with vascular compromise and bile leakage Case report

Abstract

Introduction: The liver is more frequently injured in high-energy abdominal trauma, with an incidence between 1% and 8%. Traumatic injuries to the bile ducts are infrequent.

Clinical cases: We present two patients with severe liver trauma and extrahepatic vascular and bile duct involvement and the surgical approach to preserve both lobes functionally:

1-year-old male, grade V liver trauma, incomplete injury to the right portal vein, at the level of the bifurcation and the left hepatic bile duct. The portal and bile duct damage was repaired. Two-year-old female, blunt abdominal trauma, injury to the parenchyma of the right lobe of the liver, whole section of the left hepatic duct, and associated pancreatic contusion. In both cases, a Roux-en-Y hepatic jejunostomy was performed, and both lobes were preserved.

Conclusion: In complex liver trauma involving both lobes, the evolution depends on the quality of the residual mass. Conservative surgery with vascular and biliary reconstructions avoids acute liver failure, allows time to gain until the funct.