Clinical Challenges in Trauma Surgery: Penetrating Liver Trauma

In this episode, our team discusses the management of penetrating liver trauma both before, during, and after surgery. Listen in for helpful tips such as how to perform an intraoperative air cholangiogram, creating an occlusion catheter from a red rubber and a Penrose, and much more!

Hosts: 

Elliott R. Haut, MD, PhD, a senior, nationally recognized name in trauma and acute care surgery at Johns Hopkins University. Dr. Haut is a past president of The Eastern Association for the Surgery of Trauma (EAST). 

Marcie Feinman, MD, MEHP, the current program director of General Surgery Residency at Sinai Hospital of Baltimore and editorial board member of SCORE. She received her Masters in Education in the Health Professions from Johns Hopkins. 

David Sigmon, MD, MMEd, a PGY-6 resident at the University of Illinois at Chicago who plans on going into trauma surgery. He did two years of research in surgical education at the University of Pennsylvania where he also received his Master’s in Medical Education. 

LITERATURE

1.     Murphy PB, de Moya M, Karam B, et al. Optimal timing of venous thromboembolic chemoprophylaxis initiation following blunt solid organ injury: meta-analysis and systematic review. Eur J Trauma Emerg Surg. Published online September 18, 2021. https://pubmed.ncbi.nlm.nih.gov/34537859/

2.     Kozar RA, Crandall M, Shanmuganathan K, et al. Organ injury scaling 2018 update: Spleen, liver, and kidney. J Trauma Acute Care Surg. 2018;85(6):1119-1122.

https://pubmed.ncbi.nlm.nih.gov/30462622/

3.     Kodadek LM, Efron DT, Haut ER. Intrahepatic balloon tamponade for penetrating liver injury: rarely needed but highly effective. World J Surg. 2019;43(2):486-489.
https://pubmed.ncbi.nlm.nih.gov/30280221/

4.     EAST Practice Management Guidelines: Selective Nonoperative Management of Hepatic Injury, Blunt

https://www.east.org/education-career-development/practice-management-guidelines/details/hepatic-injury-blunt-selective-nonoperative-management-of

5.     WEST Nonoperative Management of Adult Blunt Hepatic Trauma Algorithm
https://www.westerntrauma.org/wp-content/uploads/2020/08/Non-Operative-Management-of-Adult-Blunt-Hepatic-Trauma-Algorithm_FINAL.svg

6.   THE JOURNAL OF TRAUMA AND ACUTE CARE SURGERY 3-MINUTE EXPERT CONSULT VIDEO: “BALLOON TAMPONADE FOR PENETRATING LIVER TRAUMA.
https://journals.lww.com/jtrauma/Pages/videogallery.aspx?videoId=13

7.     Coccolini F, Coimbra R, Ordonez C, et al. Liver trauma: WSES 2020 guidelines. World J Emerg Surg. 2020;15:24.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7106618/

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