Treatment of traumatic lesions of the hepatic artery [Il trattamento delle lesioni traumatiche dell'arteria epatica.

Injuries to the porta hepatis, which are difficult to diagnose and require variable treatment, are rare. The mortality for the vascular injuries is directly correlated to the uncontrolled intraabdominal hemorrhage and the treatment requires primarily bleeding control. This paper reports a case of a laceration of the left hepatic artery in a young multi traumatized patient (due to a car accident). The hepatic artery injury was successfully managed by primary closure. Even if the treatment of the extra hepatic injuries of the hepatic artery is still controversial, standardized therapy approaches have been proposed. The repair of the hepatic artery is an occasional option. The simple ligation is the most common option, in fact the oxygen extraction from the portal venous blood increases if the artery is ligated and this is sufficient for a adequate hepatocellular function in a healthy liver. In reality, in literature, damages to the liver due to artery ligatures are described even in the case of a good portal flow. Repairing hepatic artery injuries should always be taken into consideration after having made necessary evaluations on the general conditions of the patient because it is preferable to attempt to bring the patient back to the "status quo ante" and therefore avoid possible complications.