EVALUATION OF MANAGEMENT OPTIONS FOR TRAUMATIC LIVER INJURIES | ||
| The Egyptian Journal of Surgery | ||
| Article 4, Volume 31, Issue 1, January 2012, Pages 16-23 PDF (1.24 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2012.367269 | ||
| Authors | ||
| Hossam Hamdy1; Maged Mahmoud Nasr1; Magdy Elsebae* 1; Hisham Abou Eisha2; Omar Sherif2 | ||
| 1Theodore Bilharz Research Institute | ||
| 2Departments of General Surgery, Cairo University | ||
| Abstract | ||
| Introduction: Hepatic trauma represents a significant management challenge that requires a high index of suspicion, rapid investigation, accurate classification and well-defined management protocols. Aim of the work: The purpose of this work is to review 0ur experience of blunt or penetrating injuries regarding the available diagnostic modalities and current management options. Methods: This is a retrospective study included 42 consecutive patients with hepatic trauma. Patients with associated major extra-abdominal injury were excluded from the study. After aggressive initial resuscitation; all patients were subjected to full clinical examination, routine blood investigations, Plain xrays film evaluation of the abdomen and chest, ultrasound abdomen focused for trauma and computed tomography (CT) of the abdomen/pelvis after the patients became hemodynamically stable. Results: 32 patients with blunt liver injuries, conservative - non operative - management was done in 23 of them. Complications (five patients) were delayed hemorrhage (two cases), perihepatic abscess (one case), and biloma (two cases). The remaining 9 patients had (laparotomy and proceed). 10 patients with penetrating liver injuries, four of them were treated conservatively- non-operatively without complications. The remaining 6 patients had (laparotomy and proceed). Conclusion: Non-operative management (NOM) of liver injury has generally become feasible treatment. The primary focus for the surgeon should be the selection of appropriate patient and early recognition of liver injury and surgical intervention when such conservative management fails. | ||
| Keywords | ||
| Liver trauma; injury severity score; non-operative management; outcome; treatment failure | ||
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