Trauma hepático grave: relato de caso e cirurgia de controle de danos em hospital de referência no Tocantins

Severe hepatic trauma represents a major therapeutic challenge, particularly in the presence of hemodynamic instability. This report describes a 19-year-old male patient who sustained blunt abdominal trauma, presenting with massive hemoperitoneum and a grade IV liver injury. The patient underwent exploratory laparotomy with hepatic packing as a damage control surgery strategy. After stabilization in the intensive care unit and arteriography showing no evidence of active bleeding, surgical re-exploration was performed 72 hours later, with removal of the packs and confirmation of hemostasis. The case demonstrates the applicability of damage control surgery in the management of severe hepatic trauma, highlighting the importance of physiological stabilization and a multidisciplinary approach.