article = {SCR-2021-1-113}
title = {Pedicled Tubular Omental Patch for Tamponade of Transfixing Gunshot Bilobar Liver Injury: A Case Report}
journal = {Surgical Case Reports}
year = {2021}
issn = {2613-5965}
doi = {http://dx.doi.org/10.31487/j.SCR.2021.01.13}
url = {https://www.sciencerepository.org/pedicled-tubular-omental-patch-for-tamponade-of-transfixing-gunshot_SCR-2021-1-113 
author = {Artur  Zanellato,Rory  Thompson,Gabriella  Zanellato,Iwan  Collaco,Simon  Paterson-Brown,}
keywords = {Case report, omental patch, trauma, liver, hepatic}
abstract ={Introduction: Liver injuries are frequent in abdominal trauma and may be managed using a variety of
methods. The operative management of deep, penetrating wounds generally involves balloon tamponade of
the wound tract using a Sengstaken-Blakemore catheter.
Case Presentation: A haemodynamically unstable 34-year-old male with multiple thoracoabdominal
gunshot wounds was transferred to the operating theatre. At laparotomy, a grade 3 transfixing (through and
through) bilobar hepatic wound was discovered with active hemorrhage. Unfortunately, no suitable balloon
catheters were available, so, as an alternative, tamponade of the wound tract was successfully achieved
using a tubular omental patch.
Discussion: Omental patches are commonly used in the management of perforated duodenal ulcers and
have been used to prevent recurrence following hepatic cyst de-roofing. To the authors’ knowledge, this is
the first description of this technique for the management of penetrating bilobar transfixing hepatic injury.
Conclusion: A tubular omental patch may be used to achieve tamponade of deep wounds in penetrating
hepatic trauma. This could be a particularly useful technique in resource-poor environments, or where a
suitable balloon catheter is otherwise unavailable.}