A case of type IIIb liver injury with unstable pelvic fracture successfully treated with acute non-operative management using multidisciplinary therapeutic approaches

DOI
  • Konda Tomoaki
    Department of Trauma and Critical Care Medicine, Kyorin University, School of Medicine Department of Trauma and Critical Care Medicine, Kyorin University, School of Medicine
  • Ochiai Koji
    Department of Trauma and Critical Care Medicine, Kyorin University, School of Medicine Department of Trauma and Critical Care Medicine, Kyorin University, School of Medicine
  • Tarui Takehiko
    Department of Trauma and Critical Care Medicine, Kyorin University, School of Medicine
  • Inada Narisaku
    Department of Trauma and Critical Care Medicine, Kyorin University, School of Medicine Department of Trauma and Critical Care Medicine, Kyorin University, School of Medicine
  • Toki Masao
    Department of Gastroenterology, Kyorin University, School of Medicine
  • Hisamatsu Tadakazu
    Department of Gastroenterology, Kyorin University, School of Medicine
  • Yamada Kenji
    Department of Trauma and Critical Care Medicine, Kyorin University, School of Medicine
  • Yamaguchi Yoshihiro
    Department of Trauma and Critical Care Medicine, Kyorin University, School of Medicine Department of Trauma and Critical Care Medicine, Kyorin University, School of Medicine

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  • 不安定型骨盤骨折を併発した III b型肝損傷に急性期非手術療法を行い良好な経過をたどった1例

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Abstract

<p>A 20-year-old man was transferred after run over by a car. He was in shock, and enhanced CT using resuscitative endovascular balloon occlusion of the aorta (REBOA) revealed type III b liver injury with unstable pelvic fracture. Extravasation was treated with transcatheter arterial embolization (TAE). Biliary peritonitis developed after admission, and was successfully treated with percutaneous drainage and endoscopic nasobiliary drainage (ENBD). He was discharged on 63 hospital-days. Even for severe liver injury with unstable circulatory status, acute non-operative management, utilizing multidisciplinary approaches such as CT with REBOA, TAE, percutaneous drainage, and ENBD is a useful option for good prognosis.</p>

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