Control of nonhepatic intra-abdominal hemorrhage with temporary packing

The use of temporary packing to obtain hemostasis has long been an adjunct for surgical procedures in the pelvic area and has recently become an acceptable approach to control hemorrhage resulting from hepatic injuries. In an unstable patient with coagulopathy and diffuse capillary bleeding, packing may be the easiest way to control intra-abdominal bleeding through the simple effect of tamponade. The patient can be re-explored after a period of stabilization, when a more definitive control of hemostasis can be undertaken. Herein, we report six patients with severe underlying disease states that contributed to massive intra-abdominal bleeding refractory to control by conventional means when temporary packing was used to control hemorrhage.