Emergency Strategies and Trends in the Management of Liver Trauma

Overview

Journal Front Med

Specialty General Medicine

Date 2012 Jun 8

PMID 22673827

Citations 5

Authors

Hongchi Jiang

Jizhou Wang

Affiliations

Soon will be listed here.

Abstract

The liver is the most frequently injured organ during abdominal trauma. The management of hepatic trauma has undergone a paradigm shift over the past several decades, with mandatory operation giving way to nonoperative treatment. Better understanding of the mechanisms and grade of liver injury aids in the initial assessment and establishment of a management strategy. Hemodynamically unstable patients should undergo focused abdominal sonography for trauma, whereas stable patients may undergo computed tomography, the standard examination protocol. The grade of liver injury alone does not accurately predict the need for operation, and nonoperative management is rapidly becoming popular for high-grade injuries. Hemodynamic instability with positive focused abdominal sonography for trauma and peritonitis is an indicator of the need for emergent operative intervention. The damage control concept is appropriate for the treatment of major liver injuries and is associated with significant survival advantages compared with traditional prolonged surgical techniques. Although surgical intervention for hepatic trauma is not as common now as it was in the past, current trauma surgeons should be familiar with the emergency surgical skills necessary to manage complex hepatic injuries, such as packing, Pringle maneuver, selective vessel ligation, resectional debridement, and parenchymal sutures. The present review presents emergency strategies and trends in the management of liver trauma.

Citing Articles

Hu W, Xu Z, Shen X, Gu Y, Dai Z, Chen J BMC Surg. 2021; 21(1):16.

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Treatment strategy for hepatic trauma.

Yu W, Li Q, Gong J Chin J Traumatol. 2016; 19(3):168-71.

PMID: 27321299 PMC: 4908222. DOI: 10.1016/j.cjtee.2015.09.011.

Spontaneous rupture of the liver in a patient admitted for subarachnoid hemorrhage.

Zatelli M, Comai A Int J Surg Case Rep. 2014; 6C:15-8.

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The utility of CT for predicting bile leaks in hepatic trauma.

LeBedis C, Anderson S, Mercier G, Kussman S, Coleman S, Golden L Emerg Radiol. 2014; 22(2):101-7.

PMID: 25146931 DOI: 10.1007/s10140-014-1262-9.

Spontaneous rupture of a hepatic epithelioid angiomyolipoma: damage control surgery. A case report.

Occhionorelli S, Dellachiesa L, Stano R, Cappellari L, Tartarini D, Severi S G Chir. 2013; 34(11-12):320-2.

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