Intraluminal Balloon Exclusion in Surgically Treating Hepatic Rupture with Hepatic Vein Injury

We present a case of hepatic rupture with hepatic vein injury following blunt trauma treated surgically by the intraluminal balloon exclusion technique. A 29-year-old woman was struck on the upper abdomen in a traffic accident. After admission, CT and ultrasonography demonstrated intra-abdominal hemorrhage and typeIIIb liver injury (JAST classification). Laparotomy was performed about 2 hours after injury, and revealed massive hemorrhage, severe injury to the lateral and medial segments of the liver, and injury to the left hepatic vein. Resectional debridement was immediately carried out to access the injured vein. A balloon catheter was introduced through the completely transected left hepatic vein, and inflated to obtain control of bleeding, then the vein was repaired with 4-0 prolene sutures which were tied after removing the occluding catheter. The patient was discharged 25 days after operation with an uneventful recovery. We think that the intraluminal balloon exclusion technique is an effective procedure for transected left hepatic vein injury.