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Cirujano general

Print version ISSN 1405-0099

Abstract

VARGAS-AVILA, Arcenio Luis et al. Management of perforating liver injury with Bakri balloon. Cir. gen [online]. 2019, vol.41, n.1, pp.47-53.  Epub Oct 02, 2020. ISSN 1405-0099.

Introduction:

Trauma injuries are the leading cause of death in México in patients from one to 44 years old. In abdominal trauma, the liver is the organ most frequently affected because of its location and size. Of the patients admitted in trauma centers, 5% have liver injuries. Complex liver injuries account for 10-30% of them, with a high mortality reported from 40-80%. The delay in the recognition of intra-abdominal injuries can cause early death due to hemorrhage or belatedly because of visceral injuries. The main cause of death in liver injuries is massive hemorrhage, which is associated with a mortality rate of 50-54% in the early hours of admission, reaching 80% in patients undergoing surgery. The Bakri balloon is a medical device made with silicon that was described in 1992 by Younes Bakri MD, who is an Obstetrician-Gynecologist. It was designed to perform an intrauterine tamponade and its mechanism of action is based on the increase of intraluminal pressure on the uterine wall, and consequently, on the uterine vasculature.

Case-report:

We report the case of a 39-year-old male patient who arrived at our emergency hospital unit after suffering a stab wound in the right hemithorax. He had signs of hypovolemic shock, so we started intensive reanimation and then sent him to the surgical room, where a transfixed grade V liver injury in the right lobe was found, which was managed successfully with a Bakri balloon that was set into the tunnel of the liver injury. The patient was discharged on the eighth day without any postsurgical complications.

Conclusion:

The use of a Bakri balloon, not previously described for handling this type of injury, is an excellent alternative with good outcomes.

Keywords : Balloon occlusion; abdominal injuries; stab wounds; liver injuries; hemoperitoneum.

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