Hepatic Packing in Major Hepatic Trauma

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To the Editor.—I read with great interest the recent article of Stain et al1 in the October 1988 issue of the Archives. Although I certainly agree with their major conclusion, ie, that hemorrhage is the major cause of mortality in patients with severe liver injury, I must take issue with their relative condemnation of hepatic packing with planned reexploration for obtaining hemostasis in such patients. I submit a report of a recent case that supports the practice of hepatic packing in major hepatic trauma, including juxtahepatic venous injury. Report of a Case. —A 17-year-old healthy male patient was involved in a motor vehicle accident May 18, 1988. He was admitted while in shock to a community hospital in rural Georgia. After a brief attempt at resuscitation he underwent celiotomy and was found to have exsanguinating hemorrhage from the liver. Due to the limited resources in this small hospital,

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