A CASE OF RIGHT HEPATECTOMY AND RIGHT RENAL ARTERY RECONSTRUCTION FOR SEVERE HEPATIC INJURY AND RIGHT RENAL ARTERY INJURY

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  • MATSUDA Masaki
    Department of Emergency and Critical Care Medicine, Saitama Medical Center, Saitama Medical University
  • SAWANO Makoto
    Department of Emergency and Critical Care Medicine, Saitama Medical Center, Saitama Medical University

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  • 肝損傷 III bおよび右腎動脈損傷に対し肝右葉切除かつ右腎動脈再建を同時に施行した1例

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Abstract

<p>　　Damage control surgery is generally the treatment strategy of choice for patients at high risk of coagulopathy and hypothermia due to severe liver injury (SLI) and massive hemoperitoneum (MH). In this context, abbreviated surgery is frequently employed as the primary surgical procedure for patients with comorbid injuries. We report a case of SLI and renal artery injury (RAI) that was successfully treated with primary definitive repair. The patient, an 18 y.o. male, was injured in a traffic accident. CE-CT revealed SLI with MH and RAI. He underwent urgent laparotomy. First the hemodynamics were stabilized by massive transfusion and bleeding control. Then, we completed right hepatectomy and reconstruction of the artery. Even in cases of abdominal injury with MH, precise diagnosis and identification of the source of bleeding are important, as they warrant early hemodynamic stabilization and allow the prolonged operative time necessary for primary definite repair.</p>

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