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2016 ; 23
(ä): 33-5
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BioGlue for traumatic liver laceration
#MMPMID27085105
Daniele E
; Dissanaike S
Int J Surg Case Rep
2016[]; 23
(ä): 33-5
PMID27085105
show ga
INTRODUCTION: Advances in diagnostic imaging and monitoring have led to a shift
towards primary non-operative management for most blunt liver injuries.
Hemostatic biologic agents are a potential adjunct in the treatment of bile leak,
especially in patients requiring surgery for drainage of a biloma. PRESENTATION
OF CASE: We present a 31year old woman who presented to the hospital after a
motor vehicle accident. She was found to have a Grade 4 liver injury causing
hemoperitoneum. The patient was taken immediately for an exploratory laparotomy
where the laceration was packed with an absorbable hemostatic mesh. On clinic
follow-up one week after discharge, the patient was found to have a bile leak. An
ERCP was performed and a stent was placed over the location of the leak. The
patient underwent laparotomy the following day for evacuation of her bilomas. The
liver laceration was identified and remained at the same depth. CryoLife Bioglue
was used to seal the laceration. DISCUSSION: Given the high volume biloma, it is
unlikely this patient would have been successfully treated without laparotomy. As
such, this was an ideal opportunity to utilize Bioglue as an adjunct to seal the
liver laceration, and thus potentially the area of bile extravasation. The
diversion of drainage using ERCP was likely to have reduced the volume of bile
leak substantially, which would also have helped increase the efficacy of the
procedure. CONCLUSION: The case presented demonstrates a novel and safe option
for the delayed repair of traumatic lacerations.
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