Monday, December 10, 2012
A man in his 20s is brought in as a trauma victim. He is an unrestrained passenger in a high speed motor vehicle accident. His GCS is 7 and he is intubated in the trauma bay. The patient is hemodynamically unstable with tachycardia and hypotension. An abdominal wall contusion is noted and there are several rib fractures. An exploratory laparotomy for shock is undertaken.
Blood is found in the abdomen. The hemoperitoneum is drained and laparotomy pads are placed in all four quadrants, along the peri-colic gutters, and into the pelvis. A large liver laceration is noted and manual compression of the liver is started. Because of ongoing bleeding, the following procedure is performed with a vascular clamp:
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