Damage control surgery for grade IV blunt hepatic injury with multiple organ damage in a child: a case report

• DOI: 10.1186/s40792-021-01348-8
• Publication Date: 2021-12-20T10:03:12Z
• Authors: Jun Soma; Daisuke Ishii; Hisayuki Miyagi; Seiya Ishii; Keita Motoki; Hidemasa Kawabata; Shunta Ishitoya; Masahiro Hagiwara; Naohiro Kokita; Masatoshi Hirasawa
• Keywords: Damage Control Surgery; Exploratory laparotomy; Damage control

Intra-abdominal hemorrhage caused by blunt hepatic injury is a major cause of morbidity and mortality in patients with abdominal trauma. Some these require laparotomy, rapid decision-making life-saving surgery are essential. Damage control (DC) useful for treating children critical situations. We performed this technique to treat an 8-year-old boy grade IV multiple organ damage. This the first report use ABTHERA Open Abdomen Negative Pressure Therapy System (KCI, now part 3 M Company, San Antonio, TX, USA) DC rescue patient without neurological sequelae.An was brought emergency department our hospital after being run over motor vehicle. He had injury, thyroid bilateral hemopneumothorax. Although he hemodynamically stable, patient's altered level consciousness, presence sign peritoneal irritation, suspicion intestinal led us perform exploratory laparotomy. As strategy, we gauze packing from liver covered abdomen improve general condition. Eighteen days admission, diagnosed biliary fistula, which improved percutaneous external drainage. no sequelae discharged 102 injury.The strategy effective severe injury. opted because have less hemodynamic reserve than adults, believe that using before appearance trauma triad death could save lives outcomes. During conservative management, it important adopt multistage, flexible approach achieve good outcome.