Selective vascular occlusion with staged hemihepatectomy for blunt liver trauma

Background: A 23-year-old man with extensive blunt trauma to the right lobe of the liver in whom adequate haemostasis could not be achieved by selecti ve suturing and packing was encountered. Contributing factors to poor haemo stasis included massive transfusion, hypothermia and acidosis. Methods: Hepatic haemostasis was achieved by selective intrahepatic ligatio n of the right hepatic pedicle and packing. Results: Alter resuscitation and stabilization in the intensive care unit, a right hemihepatectomy was performed 14 h later. Conclusions: Tnc present case describes a modification of the Pringle manoe uvre, termed 'selective Pringle manoeuvre'. This technique is a useful addi tional strategy for the management of uncontrollable bleeding in massive he patic trauma.