Injuries to the juxtahepatic veins represent a small proportion of all liver injuries but constitute the most challenging and deadly form of hepatic trauma. Recombinant activated factor VII, established as a crucial therapy for enhancing hemostasis in hemophiliacs with inhibitors, has also been used to correct coagulopathy after traumatic injury. We report two children with hepatic venous injury requiring perihepatic packing and recombinant activated factor VII to successfully control hemorrhage.
Get full access to this article
View all access options for this article.
References
1.
MooneyD.P.Multiple trauma: Liver and spleen injury.Curr Opin Pediatr2002; 14: 482–5.
2.
GrossM., LynchF., CantyT.Management of pediatric liver injuries: A 13-year experience at a pediatric trauma center.J Pediatr Surg1999; 34: 811–7.
3.
BondS.J., EichelbergerM.R., GotschallC.S.Nonoperative management of blunt hepatic and splenic injury in children.Ann Surg1996; 223: 286–9.
FabianT.C., CroceM.A., StanfordG.G.Factors affecting morbidity following hepatic trauma: a prospective analysis of 482 injuries.Ann Surg1991; 213: 540–8.
6.
BuckmanR.F., MiraliakbariR., BadellinoM.M.Juxtahepatic venous injuries: a critical review of reported management strategies.J Trauma2000; 48: 978–84.
7.
MartinowitzV., KenetG., LuboshitzA.Recombinant activated factor VII for adjunctive hemorrhage control in trauma.J Trauma2001; 51: 431–8.
8.
O'NeillP.A., BluthM., GlosterE.S.Successful use of recombinant activated factor VII for trauma-associated hemorrhage in a patient without preexisting coagulopathy.J Trauma2002; 52: 400–5.
9.
HaasT., InnerhoferP., KuhbacherG.Successful reversal of deleterious coagulopathy by recombinant factor VIIa.Anesth Analg2005; 100: 54–8.
10.
VanekT., StrakaZ., HrabakJ.Use of recombinant activated factor VII in cardiac surgery for an effective treatment of severe intractable bleeding.Jpn Heart J2004; 45: 855–60.
11.
ZimringJ.C.Appropriate use of recombinant factor VIIa: An expanding and unanswered question.Transfusion2004; 44: 1544–6.
12.
GhaorashianS., HuntB.J.“Off-License” use of recombinant activated factor VII.Blood Rev2004; 18: 245–59.
13.
HednerU., ErhardtsenE.Potential role for rFVIIa in transfusion medicine.Transfusion2002; 42: 114–24.
14.
PachterH.L., SpencerF.C., HofstetterS.R.Significant trends in the management of hepatic trauma.Ann Surg1992; 215: 492–502.
