[Perihepatic packing combined with wrapping in the treatment of major bi-lobar hepatic trauma].

After the spleen the liver is the most exposed organ to injury in abdominal blunt trauma. The improvement in imaging techniques and in anesthesia and intensive care have contributed to a fallen in mortality rate and an enhanced possibility in non-operative management. In unstable patients the packing may be used to defer the definitive operation. The Authors report a case of liver injury of two lobes where the packing was followed by liver wrapping with an absorbable mesh. The patient, a female aged 67, resulted to have a bilobar liver injury of IV degree in the injury severity score. The delay of reoperation was 15 days. The procedure was complicated by a subphrenic abscess, successfully managed with non-operative procedures. Wrapping after liver packing may be considered a good option in unstable patient affected, by severe liver injuries after blunt abdominal traumas.