To the Editor.—I read with great interest the recent article of Stain et al1 in the October 1988 issue of the Archives. Although I certainly agree with their major conclusion, ie, that hemorrhage is the major cause of mortality in patients with severe liver injury, I must take issue with their relative condemnation of hepatic packing with planned reexploration for obtaining hemostasis in such patients. I submit a report of a recent case that supports the practice of hepatic packing in major hepatic trauma, including juxtahepatic venous injury.
Report of a Case. —A 17-year-old healthy male patient was involved in a motor vehicle accident May 18, 1988. He was admitted while in shock to a community hospital in rural Georgia. After a brief attempt at resuscitation he underwent celiotomy and was found to have exsanguinating hemorrhage from the liver. Due to the limited resources in this small hospital,
FERGUSON CM. Hepatic Packing in Major Hepatic Trauma. Arch Surg. 1989;124(4):508–509. doi:10.1001/archsurg.1989.01410040118030
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