Temporary bleeding control by intrathoracic transdiaphragmatic -Foley´s catheter application in torrential transdiaphragmatic bleeding

Directorate for Trauma and Burns, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand Medical School, Johannesburg, Republic of South Africa1 (Academic Head, Division of Trauma: Prof. Elias Degiannis), Department of Surgery, 4th Surgical Clinic, “Attikon” University Hospital, Athens, Greece2 (Director: Vassilios Smyrniotis), and the Department of Procto-Surgery, St. Marienhospital, Vechta, Germany3 (Medical Director: Dr. Olaf Hagemann).

This case reports presents a young male patient with thoracoabdominal trauma caused by a stab to the posterior chest and consecutive torrential transdiaphragmatic bleeding into the intercostal drain that necessitated thoracotomy. Blind insertion of a Foley´s catheter through the diaphragmatic defect controlled the exsanguinating bleeding from the abdominal activity that had caused the hemothorax. On laparotomy, it was found to occlude a defect in the anterior wall of the inferior (IVC) vena cava – this is why the patients survived..
Conclusion: The purpose of this case report is not to show that “luck favours the brave” but it is to support the use of Foley´s catheter balloon in penetrating trauma with torrential bleeding from liver tracts in preparation of definitive control of the injury to the liver parenchyma or its´ major vessels.
Keywords: Stab chest, penetrating, thoracoabdominal injury, balloon occlusion, IVC