Research Article
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Blunt Abdominal Trauma–Induced Hepatic Artery Propria Rupture: Case Report and Treatment Discussion

Year 1978, Volume: 31 Issue: 4, 1341 - 1356, 31.12.1978

İsmail Kayabalı

https://izlik.org/JA77BF57WA

Abstract

We report a 26-year-old man who presented 15 hours after a traffic accident with blunt abdominal trauma and signs of intra-abdominal hemorrhage. Emergency laparotomy revealed a 15 cm superficial liver laceration and complete transection of the proper hepatic artery, with intact hepatic veins and bile ducts. The distal stump of the common hepatic artery was ligated just below the gastroduodenal branch; the gallbladder was removed to guard against ischemic cholecystitis. Postoperative management included volume resuscitation, oxygen therapy, antibiotics, and serial liver function testing. On postoperative day 21, nonselective aortography demonstrated well-developed collateral flow via the pancreaticoduodenal arcade, preserving hepatic perfusion. The patient recovered uneventfully. We review hepatic arterial anatomy, collaterals, physiologic responses to hepatic artery ligation, and indications for—and technique of—arterial ligation in trauma.

Keywords

Blunt abdominal trauma Hepatic artery rupture Hepatic artery ligation Collateral circulation Hepatic ischemia

References

  • 1. Aune S, Schistad G. Carcinoid liver metastases treated with hepatic dearterialization. Am J Surg. 1972;123:715–717.
  • 2. Bengmark S, Rosengren K. Angiographic study of the collateral arterial pathways to the liver after ligation of the hepatic artery in man. Am J Surg. 1970;119:620–624.
  • 3. Bengmark S, Hafström LO. Influence of hyperventilation on serum potassium during and after liver ischemia. Eur Surg Res. 1974;6:26–31.
  • 4. Benmark S, Hafström LO. Effects of hepatic inflow occlusion on serum enzymes. Eur Surg Res. 1972;4:429–437.
  • 5. Bianchi RC, Cannell D. Accidental hepatic artery ligation in humans. Br J Surg. 1966;53:265–267.
  • 6. Brittain RS, Marchioro TL, Hermann GD, et al. Accidental hepatic artery ligation in children. J Pediatr Surg. 1973;8:859–862.
  • 7. Bushkin FL, McGregor AMC, Hawkins IF Jr, Kelley MJ. Hepatic artery dissection after abdominal trauma. Surg Gynecol Obstet. 1972;134:643–646.
  • 8. Canty TG, Aaron WS. Hepatic artery ligation for exsanguinating liver injuries in children. J Pediatr Surg. 1975;10:693–696.
  • 9. Conolly WB, Belger FO, Dunphy JE. Safe hepatic artery occlusion in dogs. Surgery. 1969;66:772–774.
  • 10. Couinaud C. Le foie: études anatomiques et chirurgicales. Masson; 1957.
  • 11. Cruveilhier JB. Vascular variations of the liver and their surgical importance. Anat Clin. 1945;7:710–733.
  • 12. Crook JN, Paris MF, Nance FC. Studies of hepatic blood flow after ligation of hepatic vessels. Am Surg. 1970;36:724–727.
  • 13. Eykens E. The meaning of hepatic artery ligation in surgery. Acta Chir Belg. 1975;74:339–349.
  • 14. Fékété F, Guillet R. Les traumatismes du foie: Rapport au 71e Congrès de l’Assoc Franç Chir. Lyon Chir. 1969;67:368–370.
  • 15. Graham RR, Cannell D. Accidental ligation of the hepatic artery without serious sequelae. Br J Surg. 1953;40:566–571.
  • 16. Haberer HV. Experimental ligation of the hepatic artery. Arch Klin Chir. 1905;78:557–592.
  • 17. Hall RR. Hyperkalaemia following hepatic artery and portal vein ligation. Br J Surg. 1972;59:125–128.
  • 18. Hepp J, Bismuth H, Hernandez C. Postoperative strictures of the biliary tree and collateral arterial patterns. Lyon Chir. 1967;63:449–452.
  • 19. Hepp J. Surgical consequences of hepatic arterial variations. J Cardiovasc Surg. 1971;12:421–429.
  • 20. Kaltiala EH, Räsänen O. Effects of hepatic artery ligation on drug metabolism by liver microsomes. Ann Chir Gynaecol. 1972;61:167–172.
  • 21. Kayabalı İ. Experimental hepatic arterialization of the portal vein. AÜ Tıp Fak Mec. 1968;21:479–496.
  • 22. Kim DK, Penneman R, Kallum B, et al. Acute renal failure after hepatic inflow interruption. Surg Clin North Am. 1972;52:703–716.
  • 23. Kolikovski N. Arterial distribution in triarterial liver blood supply patterns. Khirurgia (Sofia). 1970;23:444–450.
  • 24. Lewis RF, Lim RC Jr, Blaisdell FW. Hepatic artery ligation in massive liver hemorrhage. Surgery. 1972;71:283–288.
  • 25. Luke JC. The useful splenic artery. Surg Gynaecol Obstet. 1960;110:633–636.
  • 26. Madding GF, Kennedy PA. Hepatic artery ligation. Surg Clin North Am. 1972;52:719–728.
  • 27. Mallet-Guy P, Feroldi J, Devic G, Mallet-Guy Y. Experimental study of hepatic artery ligation and arterio-portal anastomosis. Lyon Chir. 1952;47:155–180.
  • 28. Mallet-Guy P, Kayabalı İ, Espinasse P, Braconnot P. Experimental hepatic arterialization of the portal vein: Hemodynamic data. Lyon Chir. 1968;64:713–734.
  • 29. Mallet-Guy P, Kayabalı İ, Feroldi J, Mallet-Guy Y. Ultrastructural changes after hepatic arterialization. Lyon Chir. 1968;64:725–732.
  • 30. Mallet-Guy P, Michoulier J, Espinasse P, Dolniski J. Biliary lymphatic and vascular permeation in liver. Lyon Chir. 1964;60:816–827.
  • 31. Mallet-Guy P, et al. Clinical and histologic changes after portal vein arterialization. Bull Acad Natl Med (Paris). 1968;152:293–297.
  • 32. Mallet-Guy Y, Paillot JM, Switalska C, Mallet-Guy P. Ultrastructural hepatic changes after arterial clamping. Lyon Chir. 1972;68:170–175.
  • 33. Mattioli L, Lee KR, Lee K, Holder TM. Hepatic artery ligation for infant cardiac failure due to hemangioma. J Pediatr Surg. 1975;10:859–862.
  • 34. Markowitz J, Pappaport A, Scott AC. The function of the hepatic artery in dogs. Am J Dig Dis. 1949;16:344–349.
  • 35. Myawaki H. Disturbances of intrahepatic portal flow after hepatic artery ligation in dogs. Arch Jap Chir. 1960;29:1443–1445.
  • 36. Mays ET, Polk HC Jr. Angiographic and scintigraphic assessment after hepatic artery interruption. Eur Surg Res. 1973;5(Suppl 2):33–34.
  • 37. Melliére D. Collateral arterial pathways to the liver. J Int Coll Surg. 1957;27:1–17.
  • 38. Michels NA. Collateral arterial pathways after hepatic artery ligation. Cancer. 1953;6:708–717.
  • 39. Michels NA. Variants of hepatic arterial anatomy: A systematic study. Arch Surg. 1958;76:899–906.
  • 40. Michels NA. Developmental anatomy of the liver arterial supply and collateral circula- tion. Ann Surg. 1966;163:350–366.
  • 41. Monafo WW, Terberghe JL, Kempson RC. Accidental hepatic artery ligation in humans. Arch Surg. 1966;92:643–652.
  • 42. Nagasu N, et al. Angiographic evaluation of hepatic tumors prior to surgery. Surg Gyn Obstet. 1976;143:184–190.
  • 43. Narath V. Thymic transpiration after hepatic artery ligation. Deutsch Z Chir. 1916;135:305–379.
  • 44. Paillot JM, Feroldi J, Mallet-Guy Y. Experimental clampage of the hepatic artery. Lyon Chir. 1973;69:9–12.
  • 45. Perry JF Jr, et al. Bacteriology of the human liver. Surgery. 1955;37:533–535.
  • 46. Plengvaint U, Chearanai O, Sindhvananda K, et al. Collateral arterial blood supply after hepatic artery ligation. Ann Surg. 1972;175:105–110.
  • 47. Robin B. Pathologie de l’artère hépatique. J Chir (Paris). 1967;93:597–630.
  • 48. Romieu C, Brunschwig A. Experimental study of hepatic flora in humans. Lyon Chir. 1952;47:11–17.
  • 49. Schildberg FW, Stucker FJ. Injuries of the hepatic artery and its intrahepatic branches. Bruns Beit Klin Chir. 1970;218:193–209.
  • 50. Segall H. Experimental anatomy of liver blood and bile channels. Surg Gyn Obstet. 1923;37:152–178.
  • 51. Suzuki D, Sarumaru S, Kawabe K, Honjo I. Surgical implications of hepatic arterial variations. Am J Surg. 1971;122:505–512.
  • 52. Zike WL, Safai-Shirazi S, Gulesserian HP. Hepatic artery ligation and citotoxic infusion for liver tumors. Arch Surg. 1970;110:641–642.

Künt Karın Travması Sonucu Hepatik Arter Propria Kopması: Olgu Sunumu ve Tedavi Tartışması

Year 1978, Volume: 31 Issue: 4, 1341 - 1356, 31.12.1978

İsmail Kayabalı

https://izlik.org/JA77BF57WA

Abstract

Trafik kazası sonrası künt karın travması geçiren 26 yaşındaki erkek hastada 15 saat sonra karın içi kanama bulguları izlendi. Acil laparotomide, karaciğerin sağ lobunda 15 cm’lik yüzeyel yırtık ve proper hepatik arterin tam transeksiyonu saptandı. Gastroduodenal dal altından arterik proksimal stant ligatür edilerek distal kan akımı koledosektan sağlanmaması karşın, kolekistektomi yapıldı. Postoperatif dönemde volüm replasmanı, oksijen tedavisi, antibiyotikler ve seri karaciğer fonksiyon testleri uygulandı. 21. günde yapılan nonselektif aortografi, pankreatikoduodenal arkadokolleterallerin geliştiğini gösterdi. Hasta komplikasyonsuz iyileşti. Hepatik arterin ligatüründeki cerrahi anatomi, peropera­tif yağcı dolaşım fizyopatolojisi, ligatür endikasyonları ve tekniği tartışıldı.

Keywords

Künt abdominal travma Hepatik arter kopması Arter ligatürü Kolleteral dolaşım Karaciğer iskemisi

References

  • 1. Aune S, Schistad G. Carcinoid liver metastases treated with hepatic dearterialization. Am J Surg. 1972;123:715–717.
  • 2. Bengmark S, Rosengren K. Angiographic study of the collateral arterial pathways to the liver after ligation of the hepatic artery in man. Am J Surg. 1970;119:620–624.
  • 3. Bengmark S, Hafström LO. Influence of hyperventilation on serum potassium during and after liver ischemia. Eur Surg Res. 1974;6:26–31.
  • 4. Benmark S, Hafström LO. Effects of hepatic inflow occlusion on serum enzymes. Eur Surg Res. 1972;4:429–437.
  • 5. Bianchi RC, Cannell D. Accidental hepatic artery ligation in humans. Br J Surg. 1966;53:265–267.
  • 6. Brittain RS, Marchioro TL, Hermann GD, et al. Accidental hepatic artery ligation in children. J Pediatr Surg. 1973;8:859–862.
  • 7. Bushkin FL, McGregor AMC, Hawkins IF Jr, Kelley MJ. Hepatic artery dissection after abdominal trauma. Surg Gynecol Obstet. 1972;134:643–646.
  • 8. Canty TG, Aaron WS. Hepatic artery ligation for exsanguinating liver injuries in children. J Pediatr Surg. 1975;10:693–696.
  • 9. Conolly WB, Belger FO, Dunphy JE. Safe hepatic artery occlusion in dogs. Surgery. 1969;66:772–774.
  • 10. Couinaud C. Le foie: études anatomiques et chirurgicales. Masson; 1957.
  • 11. Cruveilhier JB. Vascular variations of the liver and their surgical importance. Anat Clin. 1945;7:710–733.
  • 12. Crook JN, Paris MF, Nance FC. Studies of hepatic blood flow after ligation of hepatic vessels. Am Surg. 1970;36:724–727.
  • 13. Eykens E. The meaning of hepatic artery ligation in surgery. Acta Chir Belg. 1975;74:339–349.
  • 14. Fékété F, Guillet R. Les traumatismes du foie: Rapport au 71e Congrès de l’Assoc Franç Chir. Lyon Chir. 1969;67:368–370.
  • 15. Graham RR, Cannell D. Accidental ligation of the hepatic artery without serious sequelae. Br J Surg. 1953;40:566–571.
  • 16. Haberer HV. Experimental ligation of the hepatic artery. Arch Klin Chir. 1905;78:557–592.
  • 17. Hall RR. Hyperkalaemia following hepatic artery and portal vein ligation. Br J Surg. 1972;59:125–128.
  • 18. Hepp J, Bismuth H, Hernandez C. Postoperative strictures of the biliary tree and collateral arterial patterns. Lyon Chir. 1967;63:449–452.
  • 19. Hepp J. Surgical consequences of hepatic arterial variations. J Cardiovasc Surg. 1971;12:421–429.
  • 20. Kaltiala EH, Räsänen O. Effects of hepatic artery ligation on drug metabolism by liver microsomes. Ann Chir Gynaecol. 1972;61:167–172.
  • 21. Kayabalı İ. Experimental hepatic arterialization of the portal vein. AÜ Tıp Fak Mec. 1968;21:479–496.
  • 22. Kim DK, Penneman R, Kallum B, et al. Acute renal failure after hepatic inflow interruption. Surg Clin North Am. 1972;52:703–716.
  • 23. Kolikovski N. Arterial distribution in triarterial liver blood supply patterns. Khirurgia (Sofia). 1970;23:444–450.
  • 24. Lewis RF, Lim RC Jr, Blaisdell FW. Hepatic artery ligation in massive liver hemorrhage. Surgery. 1972;71:283–288.
  • 25. Luke JC. The useful splenic artery. Surg Gynaecol Obstet. 1960;110:633–636.
  • 26. Madding GF, Kennedy PA. Hepatic artery ligation. Surg Clin North Am. 1972;52:719–728.
  • 27. Mallet-Guy P, Feroldi J, Devic G, Mallet-Guy Y. Experimental study of hepatic artery ligation and arterio-portal anastomosis. Lyon Chir. 1952;47:155–180.
  • 28. Mallet-Guy P, Kayabalı İ, Espinasse P, Braconnot P. Experimental hepatic arterialization of the portal vein: Hemodynamic data. Lyon Chir. 1968;64:713–734.
  • 29. Mallet-Guy P, Kayabalı İ, Feroldi J, Mallet-Guy Y. Ultrastructural changes after hepatic arterialization. Lyon Chir. 1968;64:725–732.
  • 30. Mallet-Guy P, Michoulier J, Espinasse P, Dolniski J. Biliary lymphatic and vascular permeation in liver. Lyon Chir. 1964;60:816–827.
  • 31. Mallet-Guy P, et al. Clinical and histologic changes after portal vein arterialization. Bull Acad Natl Med (Paris). 1968;152:293–297.
  • 32. Mallet-Guy Y, Paillot JM, Switalska C, Mallet-Guy P. Ultrastructural hepatic changes after arterial clamping. Lyon Chir. 1972;68:170–175.
  • 33. Mattioli L, Lee KR, Lee K, Holder TM. Hepatic artery ligation for infant cardiac failure due to hemangioma. J Pediatr Surg. 1975;10:859–862.
  • 34. Markowitz J, Pappaport A, Scott AC. The function of the hepatic artery in dogs. Am J Dig Dis. 1949;16:344–349.
  • 35. Myawaki H. Disturbances of intrahepatic portal flow after hepatic artery ligation in dogs. Arch Jap Chir. 1960;29:1443–1445.
  • 36. Mays ET, Polk HC Jr. Angiographic and scintigraphic assessment after hepatic artery interruption. Eur Surg Res. 1973;5(Suppl 2):33–34.
  • 37. Melliére D. Collateral arterial pathways to the liver. J Int Coll Surg. 1957;27:1–17.
  • 38. Michels NA. Collateral arterial pathways after hepatic artery ligation. Cancer. 1953;6:708–717.
  • 39. Michels NA. Variants of hepatic arterial anatomy: A systematic study. Arch Surg. 1958;76:899–906.
  • 40. Michels NA. Developmental anatomy of the liver arterial supply and collateral circula- tion. Ann Surg. 1966;163:350–366.
  • 41. Monafo WW, Terberghe JL, Kempson RC. Accidental hepatic artery ligation in humans. Arch Surg. 1966;92:643–652.
  • 42. Nagasu N, et al. Angiographic evaluation of hepatic tumors prior to surgery. Surg Gyn Obstet. 1976;143:184–190.
  • 43. Narath V. Thymic transpiration after hepatic artery ligation. Deutsch Z Chir. 1916;135:305–379.
  • 44. Paillot JM, Feroldi J, Mallet-Guy Y. Experimental clampage of the hepatic artery. Lyon Chir. 1973;69:9–12.
  • 45. Perry JF Jr, et al. Bacteriology of the human liver. Surgery. 1955;37:533–535.
  • 46. Plengvaint U, Chearanai O, Sindhvananda K, et al. Collateral arterial blood supply after hepatic artery ligation. Ann Surg. 1972;175:105–110.
  • 47. Robin B. Pathologie de l’artère hépatique. J Chir (Paris). 1967;93:597–630.
  • 48. Romieu C, Brunschwig A. Experimental study of hepatic flora in humans. Lyon Chir. 1952;47:11–17.
  • 49. Schildberg FW, Stucker FJ. Injuries of the hepatic artery and its intrahepatic branches. Bruns Beit Klin Chir. 1970;218:193–209.
  • 50. Segall H. Experimental anatomy of liver blood and bile channels. Surg Gyn Obstet. 1923;37:152–178.
  • 51. Suzuki D, Sarumaru S, Kawabe K, Honjo I. Surgical implications of hepatic arterial variations. Am J Surg. 1971;122:505–512.
  • 52. Zike WL, Safai-Shirazi S, Gulesserian HP. Hepatic artery ligation and citotoxic infusion for liver tumors. Arch Surg. 1970;110:641–642.
There are 52 citations in total.

Details

Primary Language English
Subjects General Surgery
Journal Section Research Article
Authors

İsmail Kayabalı This is me

Publication Date December 31, 1978
IZ https://izlik.org/JA77BF57WA
Published in Issue Year 1978 Volume: 31 Issue: 4

Cite

APA Kayabalı, İ. (1978). Blunt Abdominal Trauma–Induced Hepatic Artery Propria Rupture: Case Report and Treatment Discussion. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 31(4), 1341-1356. https://izlik.org/JA77BF57WA
AMA 1.Kayabalı İ. Blunt Abdominal Trauma–Induced Hepatic Artery Propria Rupture: Case Report and Treatment Discussion. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 1978;31(4):1341-1356. https://izlik.org/JA77BF57WA
Chicago Kayabalı, İsmail. 1978. “Blunt Abdominal Trauma–Induced Hepatic Artery Propria Rupture: Case Report and Treatment Discussion”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 31 (4): 1341-56. https://izlik.org/JA77BF57WA.
EndNote Kayabalı İ (December 1, 1978) Blunt Abdominal Trauma–Induced Hepatic Artery Propria Rupture: Case Report and Treatment Discussion. Ankara Üniversitesi Tıp Fakültesi Mecmuası 31 4 1341–1356.
IEEE [1]İ. Kayabalı, “Blunt Abdominal Trauma–Induced Hepatic Artery Propria Rupture: Case Report and Treatment Discussion”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 31, no. 4, pp. 1341–1356, Dec. 1978, [Online]. Available: https://izlik.org/JA77BF57WA
ISNAD Kayabalı, İsmail. “Blunt Abdominal Trauma–Induced Hepatic Artery Propria Rupture: Case Report and Treatment Discussion”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 31/4 (December 1, 1978): 1341-1356. https://izlik.org/JA77BF57WA.
JAMA 1.Kayabalı İ. Blunt Abdominal Trauma–Induced Hepatic Artery Propria Rupture: Case Report and Treatment Discussion. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 1978;31:1341–1356.
MLA Kayabalı, İsmail. “Blunt Abdominal Trauma–Induced Hepatic Artery Propria Rupture: Case Report and Treatment Discussion”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 31, no. 4, Dec. 1978, pp. 1341-56, https://izlik.org/JA77BF57WA.
Vancouver 1.İsmail Kayabalı. Blunt Abdominal Trauma–Induced Hepatic Artery Propria Rupture: Case Report and Treatment Discussion. Ankara Üniversitesi Tıp Fakültesi Mecmuası [Internet]. 1978 Dec. 1;31(4):1341-56. Available from: https://izlik.org/JA77BF57WA