Hepatic Trauma

Abstract

EXSANGUINATION is the leading cause of death in hepatic trauma. The most recalcitrant source of hemorrhage is arterial. Roentgenographic evaluation of cadaver livers injected with barium before blunt trauma portrays disruption of tertiary branches of the hepatic artery within the depths of the liver. Such vascular lesions are beyond the reach of suturing, and the very multiplicity of arterial defects makes suture repair of individual vessels impractical.The anatomic divisions of the hepatic artery suggest that hemorrhage from a particular lobe can be immediately controlled by ligation of the artery supplying that lobe. In clinical trials this hypothesis is confirmed. . . .