Crash laparotomy with supra-celiac aortic clamping

Hornez, E.; Giral, G.; Carbonnières, Anne de; Reslinger, V.; Mocellin, N.; Bonnet, Sophie

doi:10.1016/j.jviscsurg.2017.08.011

Cited by 2 publications

(3 citation statements)

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“…The patient underwent a crash laparotomy [10]. Through the survey of the abdominal cavity, there were no clots, no organ damage, and no active bleeding in the abdominal cavity.…”

Section: Normal Rangementioning

confidence: 99%

Intraperitoneal Rupture of the Urinary Bladder Mimics an Intra-Abdominal Hemorrhage: A Case Report

Shingaki¹,

Abe²,

Ameda³

et al. 2022

Cureus

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Hemorrhagic shock due to polytrauma is a life-threatening condition, requiring immediate diagnosis of the bleeding site and determination of an appropriate hemostatic procedure. Intra-abdominal injuries and pelvic fractures are major causes of massive hemorrhage, although the appropriate hemostatic procedures are different for each injury. We present a case of intraperitoneal rupture of the urinary bladder associated with pelvic fracture, in which urine extravasation into peritoneal spaces mimics intra-abdominal hemorrhage.A 33-year-old man with a known case of schizophrenia attempted suicide by jumping down from the 4th floor of his apartment (approximately 10 meters in height). He was in a state of shock on arrival. Focused assessment with sonography for trauma (FAST) showed fluid collection around his spleen only but not the perivesical space. Pelvic X-ray showed multiple pelvic fractures. We suspected the patient was in a state of hemorrhagic shock due to intra-abdominal hemorrhage and pelvic fracture. The patient's hemodynamic status did not respond to massive fluid infusion and blood transfusion, including eight units of packed RBCs transfusion. Resuscitative endovascular balloon occlusion of the aorta was performed; however, the patient's hemodynamic status did not recover. We performed an emergency laparotomy to control the suspected intra-abdominal hemorrhage. In peritoneal space, we found a large amount of non-bloody fluid. The liver, spleen, and bowels were not injured, whereas the urinary bladder was ruptured, indicating the correct diagnosis was intraperitoneal rupture of the urinary bladder associated with pelvic fracture. The ruptured urinary bladder wall was sutured, and temporary abdominal closure was performed. A contrastenhanced CT performed after the laparotomy showed massive hemorrhage around the pelvic fracture. After arrival at the angiography room, the patient became bradycardia, and the pulsation at the carotid artery was not palpable. We performed cardiopulmonary resuscitation; however, the patient died eventually.Intraperitoneal rupture of the urinary bladder would mimic an intra-abdominal hemorrhage. Therefore, a comprehensive diagnostic-treatment approach such as a hybrid ER system would be beneficial for early and accurate diagnosis.

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“…The patient underwent a crash laparotomy [10]. Through the survey of the abdominal cavity, there were no clots, no organ damage, and no active bleeding in the abdominal cavity.…”

Section: Normal Rangementioning

confidence: 99%

Intraperitoneal Rupture of the Urinary Bladder Mimics an Intra-Abdominal Hemorrhage: A Case Report

Shingaki¹,

Abe²,

Ameda³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…The abdominal aortic compression/occlusion is a method of supraceliac aortic occlusion performed on the premise of laparotomy [18]. This aortic occlusion is when the assistant manually compresses the proximal aorta of the bifurcation of the celiac artery in the lesser omentum as soon as the upper abdomen is opened at the time of crash laparotomy.…”

Section: Abdominal Aortic Compression/occlusionmentioning

confidence: 99%

“…RTACC is appropriate in cases of concomitant thoracic trauma, and this procedure is not an option when laparotomy is not required. This method has the following disadvantages: it cannot be performed prophylactically as in RTACC, it takes a long time in cases of the previous laparotomy due to adhesions, and it is performed only by physicians who can perform laparotomy [18,20].…”

Section: Abdominal Aortic Compression/occlusionmentioning

confidence: 99%

Resuscitative Thoracotomy and Aortic Cross-Clamp and Resuscitative Endovascular Balloon Occlusion of the Aorta

Nagashima

Irahara

Ishida

et al. 2022

JEVTM

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There are three methods of aortic occlusion; RTACC (resuscitative thoracotomy with aortic cross-clamp), abdominal aortic compression/occlusion after laparotomy, and REBOA. It is essential to understand the characteristics of each methods and use them appropriately according to the situation or in combination. RTACC is characterized by its rapidity and certainty, but highly invasive. Abdominal aortic compression/occlusion is beneficial because hemostasis after laparotomy can be performed simultaneusly. Advantages of REBOA compared to RTACC are minimaly-invasiveness and safety, and disadvantages are rapidity and certainty. However, it is not necessary to discuss the superiority or inferiority of RTACC and REBOA. The appropriate determination of a combination of these tactics will increase the range of strategies. In particular, RTACC should be performed promptly for impending cardiac arrest and early conversion to REBOA can be helpful regarding to prevention of hypothermia and reduction of chest wall bleeding (To "REBOA & RTACC" instead of "REBOA vs RTACC").

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Crash laparotomy with supra-celiac aortic clamping

Cited by 2 publications

References 0 publications

Intraperitoneal Rupture of the Urinary Bladder Mimics an Intra-Abdominal Hemorrhage: A Case Report

Intraperitoneal Rupture of the Urinary Bladder Mimics an Intra-Abdominal Hemorrhage: A Case Report

Resuscitative Thoracotomy and Aortic Cross-Clamp and Resuscitative Endovascular Balloon Occlusion of the Aorta

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