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Priority Setting in Damage Control Surgery for Multiple Abdominal Trauma Following Resuscitative Endovascular Balloon Occlusion of the Aorta

Journal of Trauma and Injury 2020년 33권 3호 p.181 ~ 185
허윤정, 이석원, 김동헌,
소속 상세정보
허윤정 ( Heo Yoon-Jung ) - Dankook University Hospital Department of Trauma Surgery
이석원 ( Lee Seok-Won ) - Dankook University Hospital Department of Trauma Surgery
김동헌 ( Kim Dong-Hun ) - Dankook University Hospital Department of Trauma Surgery

Abstract


Damage control surgery (DCS) is an abbreviated laparotomy procedure that focuses on controlling bleeding to limit the surgical insult. It has become the primary treatment modality for patients with exsanguinating truncal trauma. Herein, we present the case of a 47-year-old woman with liver, kidney, and superior mesenteric vein (SMV) injuries caused by a motor vehicle collision. The patient underwent DCS following resuscitative endovascular balloon occlusion of the aorta (REBOA). In this case report, we discuss the importance of priority setting in DCS for the treatment of multisystem damage of several abdominal organs, particularly when the patient has incurred a combination of major vascular injuries. We also discuss the implications of damage control of the SMV, perihepatic packing, and right-sided medial visceral rotation. Further understanding of DCS, along with REBOA as a novel resuscitation strategy, can facilitate the conversion of uniformly lethal abdominal injuries into rescuable injuries.

키워드

Mesenteric veins; Liver; Kidney; Balloon occlusion; Surgical procedures, operative

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