Non-Operative Management of Liver Trauma

2012 ◽  
Vol 158 (2) ◽  
pp. 85-95 ◽  
Author(s):  
C Swift ◽  
Jeff Garner
BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Rohan Thakkar ◽  
Khaled Ammar ◽  
Ellen Meredith ◽  
Michael Jones ◽  
Ellen Meredith ◽  
...  

Abstract Introduction The liver is the most commonly injured intra-abdominal organ and occurs in 30% of patients undergoing laparotomy for penetrating injuries and in 15–20% of laparotomies for blunt injuries. CT scan is the investigation of choice for accurate diagnosis and categorization of hepatic injury. Management of isolated liver trauma can be by operative or non-operative management, guided mainly by haemodynamic stability of the patient irrespective to category of injury. Close observation of patients undergoing non-operative management is important; they may develop early complications that require operative intervention, including bleeding, bile leak and peritonitis. Methods A questionnaire will be sent to the General Surgery consultants and registrars within the North East of England, a region with eleven hospitals taking General Surgical admissions, two of which are regional trauma centres. This is to assess the understanding of liver trauma classification and management and their familiarity with and adherence to the regional liver trauma guidelines. Following this, the guidelines will be distributed throughout the region with accompanying teaching sessions. A follow up questionnaire will determine the improvement of regional knowledge and use of the guidelines. In parallel, the outcome of liver trauma patients within the region will be sought to look for correlation between the education and the patient’s outcome. Results Regional distribution of the results will demonstrate the change in the education of liver trauma management and the subsequent change in patient’s outcome. Results will be recorded using Excel and analysed using SPSS statistical software.


2021 ◽  
Vol 11 (3) ◽  
pp. 137-140
Author(s):  
Morgan E Jones ◽  
Ee Jun Ban ◽  
Charles H. C. Pilgrim

Non-operative management of blunt liver injury has been demonstrated as a safe and effective treatment for most grades of injury. As the severity of liver injury increases, so does the risk of complications. A 21-year-old male was brought to the trauma center following a high speed motorbike accident. He underwent a laparotomy and angioembolization for a Grade 4 liver injury. A biloma was diagnosed on Day 18 post injury, and he underwent Endoscopic Retrograde Cholangiopancreatography and biliary stenting which were unsuccessful. There were 2 re-admissions for infected perihepatic collections. In this case, an Endoscopic Retrograde Cholangiopancreatography was not a helpful procedure due to a disconnected liver segment, and morbidity occurred due to instrumentation of the biliary tree (the likely cause of infected biloma). Hepatic resection should be considered for patients who fail non-operative management. Further assessment of efficacy using a larger dataset for analysis is required.


2014 ◽  
Vol 69 (2) ◽  
pp. 157-162 ◽  
Author(s):  
R. Inchingolo ◽  
A. Ljutikov ◽  
A. Deganello ◽  
P. Kane ◽  
J. Karani

2012 ◽  
Vol 84 (6) ◽  
pp. 330-334
Author(s):  
A. Marinis ◽  
S. Rizos

2015 ◽  
Vol 8 (4) ◽  
pp. 239 ◽  
Author(s):  
Salomone Di Saverio ◽  
Gregorio Tugnoli ◽  
Francesco Cinquantini ◽  
Carlo Coniglio ◽  
Andrea Biscardi ◽  
...  

2019 ◽  
Vol 74 (5) ◽  
Author(s):  
Yashwant R. Sakaray ◽  
Vikas Gupta ◽  
Thakur D. Yadav ◽  
Naveen Kalra ◽  
Virendra Singh

2010 ◽  
Vol 26 (1) ◽  
pp. 39
Author(s):  
Mircelal Kazimi ◽  
Savas Yakan ◽  
Rasim Farajov ◽  
Murat Kilic

2020 ◽  
Vol 5 (1) ◽  
pp. e000551
Author(s):  
Adam Brooks ◽  
John-Joe Reilly ◽  
Carla Hope ◽  
Alex Navarro ◽  
Paal Aksel Naess ◽  
...  

The management of complex liver injury has changed during the last 30 years. Operative management has evolved into a non-operative management (NOM) approach, with surgery reserved for those who present in extremis or become hemodynamically unstable despite resuscitation. This NOM approach has been associated with improved survival rates in severe liver injury and has been the mainstay of treatment for the last 20 years. Patients that fail NOM and require emergency surgery are associated with increased morbidity and mortality. Better patient selection may have an impact not only on the rate of failure of NOM, but the mortality rate associated with it. The aim of this article is to review the evidence that helped shape the evolution of liver injury management during the last 30 years.


2011 ◽  
Vol 37 (6) ◽  
pp. 591-596 ◽  
Author(s):  
C. Morales ◽  
L. Barrera ◽  
M. Moreno ◽  
M. Villegas ◽  
J. Correa ◽  
...  

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