Management of hepatic artery injury: case report

The trauma surgeon encounters hepatic arterial injury only rarely. The majority of these injuries appear to be due to penetrating trauma, with few cases of hepatic artery injury secondary to blunt trauma reported in the literature. In the setting of blunt trauma, hepatic artery injury is generally accompanied by other severe injuries, and mortality remains high. We present two patients who sustained an avulsion of the left hepatic artery complicating severe blunt trauma to the abdomen and pelvis. Surgical management included ligation of the involved vessel. Both patients required management in the intensive care unit, one eventually succumbing to multisystem organ failure. The cases highlight management principles in these injuries, and treatment options are discussed.