Management of blunt hepatic trauma

Bouras, A.; Truant, Stéphanie; Pruvot, F.R.

doi:10.1016/j.jviscsurg.2010.10.004

Cited by 36 publications

(31 citation statements)

References 48 publications

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“…Liver due to its firm texture is more confidently treated by NOM [19]. In our analysis NOM succeeded in all stable isolated liver injuries but failed in 15% isolated splenic trauma.…”

Section: Discussionmentioning

confidence: 73%

Non operative management of abdominal trauma – a 10 years review

et al. 2013

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IntroductionDue to high rate of operative mortality and morbidity non-operative management of blunt liver and spleen trauma was widely accepted in stable pediatric patients, but the general surgeons were skeptical to adopt it for adults. The current study is analysis of so far largest sample (1071) of hemodynamically stable blunt liver, spleen, kidney and pancreatic trauma patients managed non operatively irrespective of severity of a single /multiple solid organ injury or other associated injuries with high rate of success.MethodsExperience of 1071 blunt abdominal trauma patients treated by NOM at a tertiary care National Trauma Centre in Oman (from Jan 2001 to Dec 2011) was reviewed, analyzed to determine the indications, methods and results of NOM. Hemodynamic stability along with ultra sound, CT scan and repeated clinical examination were the sheet anchors of NOM. The patients were grouped as (1) managed by NOM successfully, (2) failure of NOM and (3) directly subjected to surgery.ResultsDuring the 10 year period, 5400 polytrauma patients were evaluated for abdominal trauma of which 1285 had abdominal injuries, the largest sample study till date. Based on initial findings 1071 patients were admitted for NOM. Out of 1071 patients initially selected 963 (89.91%) were managed non operatively, the remaining 108 (10.08%) were subjected to laparotomy due to failure of NOM. Laparotomy was performed on 214(19.98%) patients as they were unstable on admission or had evidence of hollow viscous injury.ConclusionNOM for blunt abdominal injuries was found to be highly successful in 89.98% of the patients in our study. Management depended on clinical and hemodynamic stability of the patient. A patient under NOM should be admitted to intensive care / high dependency for at least 48-72 hours for close monitoring of vital signs, repeated clinical examinations and follow up investigations as indicated.

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“…Liver due to its firm texture is more confidently treated by NOM [19]. In our analysis NOM succeeded in all stable isolated liver injuries but failed in 15% isolated splenic trauma.…”

Section: Discussionmentioning

confidence: 73%

Non operative management of abdominal trauma – a 10 years review

et al. 2013

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“…Injuries to the liver can sometimes be treated conservatively, due to the firm architecture of the liver. 15 However, careful monitoring is required in such cases. When laparotomy is decided, then a thorough examination of the abdominal organs must be done.…”

Section: Resultsmentioning

confidence: 99%

A study of blunt injury abdomen in patients attending the emergency department in a tertiary hospital

Yogish

Venkateswaran

2016

Int Surg J

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“…It happens during a car accident, or a penetrating foreign object such as a knife [4]. It dissipates through and around the structure of the liver [5]. Normally, sport persons feel a traumatized liver with severe injury during sport events.…”

Section: Physical Damagementioning

confidence: 99%

Stem Cell Therapeutics of Acute Liver Diseases, Transplantation, and Regeneration

Upadhyay¹

2017

J Cell Sci Ther

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Present review article explains various causes of acute liver diseases and their therapeutics. This article describes major reasons of hepatic pathophysiological conditions and diseases including hepatitis, cholestasis, alcoholic and non-alcoholic steatohepatitis, jaundice, liver cirrhosis, carcinogenesis and many others. This article emphasizes use of proliferating hepatocytes, hepatic oval cells, adult human liver mesenchymal stem/progenitor cells, induced pluripotent stem cells (iPSCs) and hematopoietic stem cells in cell transplantation for restoration of liver structure and function. It also justified the therapeutic role of cell secreted growth factors and dietary factors required during natural healing and regeneration liver after surgery or liver transplantation. It sketches out regulatory roles of signaling pathways, expression of cell cycle regulators, growth factors, cytokines, and role of different mitogens in induction of liver stem/progenitor cells (LSPCs) after organ/stem cell transplantation. This article suggests a need for development of new advanced biomaterials, methods, technologies and stem cells for development of targeted therapies to combat and cure liver related diseases and disorders. This article also advice people for avoiding excessive use of alcohol, drugs, fats, salt, high energy diets, and iron as all are responsible of liver cirrhosis, damage and failure.

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Management of blunt hepatic trauma

Cited by 36 publications

References 48 publications

Non operative management of abdominal trauma – a 10 years review

Non operative management of abdominal trauma – a 10 years review

A study of blunt injury abdomen in patients attending the emergency department in a tertiary hospital

Stem Cell Therapeutics of Acute Liver Diseases, Transplantation, and Regeneration

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