Liver injuries and falciform ligament reinforcement for haemostasis.

Clinical data of 78 patients with liver injury treated at the Pranungklao Hospital, Nonthaburi, Thailand, from February 1986 to June 1994, were described in details with reference to severity of injury and surgical treatment modality. Patients were 71 males and 7 females ranging in age from 1.8/12 to 78 years (mean 27.4 years). Of the 78 injured, 43 patients sustained blunt liver injury, and 35 sustained penetrating injury. The severity of injury was graded into mild injury (grade 1-2) in 13 patients; moderate injury (grade 3-4) in 48 patients; and severe injury (grade 5-6) in 17 patients. Treatment included drainage alone, electric cautery or haemostatic agent, simple suture, suture ligation of bleeding points, hepatic artery ligation, resectional debridement, segmental resection, hepatectomy and perihepatic packing. In addition, calceiform ligament was used with the purpose to stop bleeding in 6 patients together with other techniques such as simple suture, traction, compression tourniquet and patch graft. Overall rate of complications and mortality were 21.79% and 8.97%, respectively.

Morgagni hernia: Report of a case.

A case of Morgagni hernia was encountered in a female patient aged 72 years, who was suffering from abdominal discomfort and shortness of breath. A preliminary diagnosis of mediastinal lipoma was suggested by computed tomography findings. However, during right-sided thoracotomy, a large Moregagni hernia containing a cluster of omentum completely enveloped in a peritoneal sac, was removed.