Balloon tamponade: an alternative in the treatment of liver trauma

Penetrating hepatic injury remains a therapeutic challenge for the surgeon. Surgical technique for the management of penetrating hepatic trauma includes balloon tamponade, which is most useful for central gunshot wounds that pass through both lobes. Our patient had two entrance wounds and no exit wounds. However, a bullet was palpable in the subcutaneous tissue just beneath the right shoulder in the supraclavicular region. A Penrose drain and red rubber catheter balloon device were placed in the abdominal cavity. The balloon device was inflated for 48 hours, after which the Penrose drain was allowed to slowly deflate and was removed. The abdomen was re-explored, found to be negative, and then closed. The patient's postoperative course was uneventful, and he was discharged on postoperative day 14. The use of balloon tamponade is an option that should be kept in the surgeon's armamentarium for use in selected patients with hepatic trauma.