Healing of Blunt Liver Injury After Non-Operative Management: Role of Ultrasonography Follow-Up

Padalino, P; Bomben, Fabio; Chiara, Osvaldo; Montagnolo, G.; Marini, A.; Zago, Mauro; Rebora, Paola

doi:10.1007/s00068-009-8250-x

Cited by 8 publications

(5 citation statements)

References 30 publications

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“…In this situation, more experienced ultrasonographers are required to follow the evolution of the lesions. Padalino et al [4] report on a long US follow-up study for the nonoperative management (NOM) of blunt liver trauma. US seems to be useful in allowing an earlier resumption of activities, tailored to the individual patient and not to fixed protocols.…”

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confidence: 99%

Time for a Comprehensive Ultrasound- Enhanced Trauma Management

Zago

2009

Eur J Trauma Emerg Surg

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confidence: 99%

Time for a Comprehensive Ultrasound- Enhanced Trauma Management

Zago

2009

Eur J Trauma Emerg Surg

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“…In a paper of Padalino et al, US was employed for a systematic follow-up of liver lesions after non-operative management (NOM). The incidence of biloma was 2.2 % over a group of 44 patients [45].…”

Section: Liver Lesions and Bilomasmentioning

confidence: 87%

Management of Post-Traumatic Complications by Interventional Ultrasound: a Review

2016

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Purpose of Review We reviewed the current literature to assess the feasibility of ultrasound-assisted and ultrasoundguided procedures for the treatment of post-traumatic complications and to address the indications and techniques of procedures. Recent Findings Non-operative strategies have been introduced in the treatment of severe trauma, and consequently, the incidence of some post-traumatic complications has increased. US can be useful both for the initial assessment of trauma patients and for the treatment of complications. Summary Ultrasound-guided and ultrasound-assisted procedures as a therapeutic tool in the management of post-trauma settings are probably underused, in comparison with their successful use in other acute settings. Some new possible fields of clinical researches are suggested.

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“…Padalino and colleagues found ultrasonography (US) to be beneficial for following up gross parenchymal liver recovery; however, small HPA are difficult to identify with standard US. 26 Contrast-enhanced US (CEUS) has more recently been suggested as a sensitive tool for follow-up imaging to detect HPA. 27 The main benefit of CEUS is the lack of radiation exposure to the patient, particularly pertinent in the paediatric population; however, this remains subjective and operator dependent.…”

Section: Discussionmentioning

confidence: 99%

The value of systematic follow-up imaging for assessing pseudoaneurysm formation after blunt and penetrating liver injury: A level 1 trauma centre experience

Patel

Mehdi

Sandhu

et al. 2021

Trauma

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Introduction Hepatic pseudoaneurysm (HPA) is a rare but potentially life-threatening sequelae of blunt or penetrating liver trauma. At our institution, an imaging protocol for liver injury patients has been developed, with repeat computed tomographic (CT) angiography of the liver 48–72 h post-admission to assess for HPA. The purpose of this study was to evaluate the utility of this imaging pathway in liver trauma for the detection of HPAs. Methods A retrospective analysis was performed on patients who were admitted to our institution between January 2014 and January 2018, found to have either blunt or penetrating liver injury on initial CT imaging. Data collection included mechanism of injury, injury severity score (ISS), American Association for the Surgery of Trauma (AAST) liver injury score, initial and follow-up CT findings and secondary intervention. Results During the study period, 149 major trauma patients were admitted with liver injuries (mean age 35.6 years; 72% male, 28% female). Seventy two percent of patients suffered blunt (median ISS = 29; median AAST = 2.89) and 28% patients suffered penetrating injuries (median ISS = 16; median AAST = 2.88). The mean time to follow-up CT was 46.1 h. Follow-up CT identified 8 (5.4%) HPAs. 5 (62.5%) of these patients were treated with embolization. ISS and AAST were not associated with pseudoaneurysm formation according to logistic regression analysis; however, ISS (OR 1.06 [1.02, 1.09; p < 0.05]) and AAST (OR 2.24, [1.31, 3.83; p < 0.05]) were associated with requirement for embolization. Conclusion Our experience indicates a role for early detection of HPAs using a dedicated trauma imaging pathway.

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Healing of Blunt Liver Injury After Non-Operative Management: Role of Ultrasonography Follow-Up

Abstract: In our experience, a long time variability for spontaneous liver repair after blunt trauma and non-operative treatment was found, but a parenchymal US normalization was evidenced in a median time shorter than that usually reported in the literature.

Cited by 8 publications

References 30 publications

Time for a Comprehensive Ultrasound- Enhanced Trauma Management

Time for a Comprehensive Ultrasound- Enhanced Trauma Management

Management of Post-Traumatic Complications by Interventional Ultrasound: a Review

The value of systematic follow-up imaging for assessing pseudoaneurysm formation after blunt and penetrating liver injury: A level 1 trauma centre experience

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