Hepatic venous injury; a case report of atriocaval shunt by a centrifugal pump

Abstract

Injury of hepatic vein confluence and retrohepatic vena cava is serious and often fatal. We report one such case that was successfully treated by the Biopump (Medtronic Bio-Medicus, Inc., Eden Prairie, Minn). A 21-year-old man was admitted due to a steering-wheel injury in a motor vehicle accident. CT scan showed extravasated contrast material around the right hepatic lobe, and a large low density area in the right hepatic lobe adjacent to the inferior vena cava, suggesting injury of the hepatic vein confluence or the retrohepatic vena cava. The patient underwent surgical treatment. Laceration of the liver was extended to the hepatic vein confluence. Right hepatic lobectomy and repair of the middle hepatic vein was successfully performed under atriocaval shunting by the Biopump.