Major hepatic vein ligation necessitated by blunt abdominal trauma

An unusual case involving avulsion of the middle and left hepatic veins secondary to blunt trauma is presented. Operative management of the injury resulted in ligation of both veins without resection of the parenchyma acutely deprived of venous outflow. The postoperative evaluation and review of the literature indicate that liver tissue will survive acute interruption of a major portion of its venous outflow. This case demonstrates that if after ligating major hepatic vein, the condition of the obstructed parenchyma stabilizes or improves under direct observation and if the condition of the patient does not deteriorate, resection may not be required.