A 35-year-old male with a stab wound on the right upper quadrant of the abdomen just below the costal margin is brought to emergency room with BP 80/50 mm Hg and pulse rate 140/min. FAST reveals blood in Right upper quadrant. Immediately the patient is taken for emergency laparotomy. To stop the bleeding, surgeon tries to occlude the free edge of lesser omentum. However, the bleeding does not stop. Which of the following structure is likely source of haemorrhage?
Correct Answer: Inferior vena cava
Description: The bleeding is likely from wounded liver. The surgeon attempts to occlude the free edge of lesser omentum also known as hepatoduodenal ligament. This maneuver is also known as Pringle's maneuver. Occlusion of hepatoduodenal ligament occludes the following structures: Hepatic aery Poal vein Common bile duct However, if the bleeding does not stop even after occlusion of these structures, the likely source of bleeding is inferior vena cava or hepatic veins.
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