The rate of success of the conservative management of liver trauma in a developing country

Buci, S.; Torba, Myftar; Gjata, Arben; Kajo, Ilir; Bushi, Gj.; Kagjini, K.

doi:10.1186/s13017-017-0135-4

Cited by 26 publications

(29 citation statements)

References 33 publications

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“…CT scan may help in subsequent Table 3 AAST liver trauma classification [24][25][26][27][28][29][30][31][32]. Diagnostic peritoneal lavage (DPL) should be considered diagnostic modality in low-resource settings, where CT scan or US is not promptly available [33]. It should be considered in the presence of massive subcutaneous emphysema in a shocked patient in whom ultrasound cannot be done and/or in the presence of free peritoneal fluid without solid organ injury in a hemodynamically stable patient.…”

Section: Diagnosismentioning

confidence: 99%

“…It should be considered in the presence of massive subcutaneous emphysema in a shocked patient in whom ultrasound cannot be done and/or in the presence of free peritoneal fluid without solid organ injury in a hemodynamically stable patient. The possibility of DPL-related complications (up to 2%) should be considered [33].…”

Section: Diagnosismentioning

confidence: 99%

“…32 Trauma Surgery, Auckland University Hospital, Auckland, New Zealand. 33 Division of Acute Care Surgery, University of Michigan Health System, Ann Arbor, MI, USA. 34 ICU Department, Papa Giovanni XXII Hospital, Bergamo, Italy.…”

Section: Funding Nonementioning

confidence: 99%

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Liver trauma: WSES 2020 guidelines

et al. 2020

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Liver injuries represent one of the most frequent life-threatening injuries in trauma patients. In determining the optimal management strategy, the anatomic injury, the hemodynamic status, and the associated injuries should be taken into consideration. Liver trauma approach may require non-operative or operative management with the intent to restore the homeostasis and the normal physiology. The management of liver trauma should be multidisciplinary including trauma surgeons, interventional radiologists, and emergency and ICU physicians. The aim of this paper is to present the World Society of Emergency Surgery (WSES) liver trauma management guidelines.

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Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

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Liver trauma: WSES 2020 guidelines

et al. 2020

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“…Bucirt et al have reported that liver injuries that was inspected during laparotomy for associated injuries had no active bleeding. 21 Richardson et al, commented that many experienced trauma surgeons apply surgical treatment for stable traumatic liver injury patients and it will have a positive impact on their survival. However, such a comment was not applicable to our study.…”

Section: Discussionmentioning

confidence: 99%

Management of traumatic liver injuries, Mafraq hospital experience, UAE

et al. 2017

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Background: The purpose of this retrospective study is to evaluate our institutional practice on the management of traumatic liver injuries and evaluate the main causes of failure of non-operative management (NOM).Methods: This is a retrospective study done in Mafraq Hospital, Abu Dhabi, UAE, during the period between January 2014 and January 2016. The patients were reviewed with regards of the grade of liver injuries, blood transfusion, imaging done, surgical intensive care unit (SICU) admission and serial vital signs and hemoglobin level. Also, we included the patient who required emergency laparotomy and damage control surgery. Focused assessment by ultrasound for trauma (FAST) was done in all liver trauma patients upon arrival to ED along with arterial blood gases, chest and pelvic X-rays. Computed tomography (CT) scans with angiography was done in all responder and stable patients. In transient responder patient CT was done on the window period of responding to resuscitation. Non-responder patients were taken immediately for exploration laparotomy, which include either control of bleeding or perihepatic packing.Results: This study included 75 patients admitted to our facility with different grades of liver injuries. 36 (48%) patients were admitted with grade I, II liver injuries which represent most of our admissions. 27 (36%) patients were admitted with grade III, 10 (13.33%) patients with grade IV while the least number was with grade V (2 patient, 2.66%). Non-operative management (NOM) or conservative treatment was successful in 34 patients admitted with grade I, II liver injuries whereas other 2 patients were explored for associated mesenteric and splenic injuries. On the patients admitted wit grade III liver injuries NOM was successful on 22 patients. The results of management of grade IV injuries showed that NOM was successful on 5 patients while the patients with grade V were managed operatively due to instability.Conclusions: Management of traumatic liver injuries is a multidisciplinary team work requiring trauma surgeon, interventional radiology, intensive care unit beside facility for trauma CT and massive blood transfusion. Management of traumatic liver injuries is depending on hemodynamic status of the patient and not the grade of injury.

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“…Blunt liver trauma can be mild, moderate or severe. Mild and moderate liver trauma can be managed conservatively without surgery [3,11,15,18].…”

Section: Conservative Treatment Of Liver Traumamentioning

confidence: 99%

Hepatic Trauma

Yahya¹

2018

Liver Research and Clinical Management

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Liver is the second most common solid organ frequently injured by blunt trauma and could be the commonest organ injured by penetrating trauma. The injury can be mild and goes undetected or detected and treated conservatively. It can be severe where the liver wounds can bleed until death. Once the patients with liver injury are resuscitated, the degree of liver injury can be evaluated using ultrasound scan and computed tomography imaging. If the patient is stable, diagnostic peritoneal lavage is very helpful when the imaging facilities are not available. Non-operative treatment of liver trauma has been proven to be valuable in 80% of patients with grade I, II, III and IV (grade I-mild injury; grade II-moderate injury; grade III and IV-severe liver injury). Laparotomy is mandatory if the patient's condition is unstable. By using the explorative laparotomy technique, the grade of liver injury is assessed, and accordingly the procedure is performed including suturing, ligation of the bleeding vessel, segmental resection, perihepatic packing, and so on. Morbidity and mortality of liver injury can be minimized with early diagnosis and appropriate management.

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The rate of success of the conservative management of liver trauma in a developing country

Cited by 26 publications

References 33 publications

Liver trauma: WSES 2020 guidelines

Liver trauma: WSES 2020 guidelines

Management of traumatic liver injuries, Mafraq hospital experience, UAE

Hepatic Trauma

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