Hepatic trauma management in polytraumatised patients

Chirurgia (Bucur). 2012 Sep-Oct;107(5):591-7.

Abstract

The specialty literature of the last decade presents the nonoperative management of the closed abdominal trauma as the treatment of choice. The purpose of this study is to highlight the importance of the optimal management of hepatic lesions considering the clinical, paraclinical and therapeutic approach. Our study is based on the analysis of the clinical and paraclinical data and also on the evaluation of the treatment results in 1671 patients with abdominal trauma affecting multiple organs who were treated at the Clinic of Surgery, County Hospital of Oradea from 2008 to 2011. The non-operative approach of the hepatic trauma, applied in 52% of the patients, was indicated in stable hemodynamic status, non-bleeding hepatic lesions on the abdominal CT, and the absence of other significant abdominal lesions. The remaining 48% were treated surgically. The postoperative evolution was free of complications in 72% of the patients while the rest of 28% presented one or more postoperative complications.

Abbreviations: CT = Computer Tomography; ISS= Injury Severity Score; AIS = Abbreviated Index of Severity; AAST = American Association for the Surgery of Trauma; ARDS = Adult Respiratory Distress Syndrome.

MeSH terms

  • Abdominal Injuries / diagnostic imaging
  • Abdominal Injuries / surgery
  • Abdominal Injuries / therapy*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Humans
  • Injury Severity Score
  • Liver / diagnostic imaging
  • Liver / injuries*
  • Male
  • Middle Aged
  • Multiple Trauma / diagnostic imaging
  • Multiple Trauma / surgery
  • Multiple Trauma / therapy*
  • Prospective Studies
  • Radiography
  • Treatment Outcome
  • Wounds, Nonpenetrating / diagnostic imaging
  • Wounds, Nonpenetrating / surgery
  • Wounds, Nonpenetrating / therapy*