Hepatic trauma revisited

Feliciano, David V.; Pachter, H. Leon

doi:10.1016/0011-3840(89)90014-2

Cited by 97 publications

(68 citation statements)

References 135 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Non-operative treatment is indicated in patients with stable hemodynamic status and isolated organ injury (4,5). In instable patients with uncontrolled bleeding, the requirement of surgery remains to be a controversial issue.…”

Section: Introductionmentioning

confidence: 99%

Methylene blue as an antioxidant agent in experimentally-induced injury in rat liver

Bozkurt¹,

Dumlu²,

Tokaç³

et al. 2015

BLL

View full text Add to dashboard Cite

Background:We aimed to test the methylene blue (MB) as a dye and also to test its antioxidant activities in devascularization-induced liver injury. Methods: Twenty rats weighing 240-280 g were randomly divided into two groups, each containing 10 rats. High-grade liver injury was induced by using a pair of long pliers with blades. MB was injected into portal vein of the rats with no hepatic injury (Group 1; control group) and those with injured livers (Group 2; injury group). Liver and hepatic function tests, paraoxonase, stimulated paraoxonase, arylesterase activity, total antioxidant, and oxidant status were evaluated before and 24 h after MB injection. Results: MB did not stain the non-perfused area. Total antioxidant status decreased signifi cantly in Group 2 at hour 24 compared to Group 1. In Group 2, total antioxidant status was lower at hour 24 compared to hour 0. Total oxidant status in Group 2 at hour 0 increased signifi cantly compared to Group 1. Total oxidant status in Group 2 at hour 24 was lower compared to that at hour 0. Lipid peroxidation parameters did not alter due to devascularization. Conclusion: MB is useful in defi ning the devascularization area. Moreover, it showed to have a benefi cial effect on oxidant status (Tab. 3, Fig. 3, Ref. 25). Text in PDF www.elis.sk.

show abstract

Section: Introductionmentioning

confidence: 99%

Methylene blue as an antioxidant agent in experimentally-induced injury in rat liver

Bozkurt¹,

Dumlu²,

Tokaç³

et al. 2015

BLL

View full text Add to dashboard Cite

show abstract

“…Types I-III hepatic injuries can usually be treated by conservative or simple surgical means. However, complex hepatic injuries (types IV and V) carry a significant mortality and often require hepatic surgery, including liver resection, combined resection and packing, or in extreme cases, transplantation [2][3][4].…”

Section: Discussionmentioning

confidence: 99%

“…Several techniques to stop the persistent hemorrhage have been described, ranging from conservative methods such as perihepatic packing to more radical interventions including hepatic artery ligation, parenchymal suturing, liver resection, and in exceptional cases, liver transplantation [2][3][4]. Even though the mortality rate of liver trauma has much decreased over the past few years [5], the treatment remains challenging for the clinician, necessitating a multidisciplinary approach.…”

Section: Introductionmentioning

confidence: 99%

Liver Transplantation for Post reperfusion Syndrome due to Surgical Packing of a Lacerated Liver

Hoti

Hogan

Hegarty

et al. 2008

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

The liver is the most frequently injured intra-abdominal organ and is the main cause of death in patients with abdominal injuries (mortality 10-15%). Grades III and IV liver injuries may present a complex problem to the surgeon. Several techniques to prevent exsanguination have been described including perihepatic packing, hepatic artery ligation, liver suturing or resection, and hepatectomy with transplantation. We report a case of a trauma patient who underwent perihepatic packing to control bleeding. Following pack removal, the patient developed severe cardiorespiratory depression resulting from postreperfusion syndrome requiring emergency total hepatectomy and liver transplantation. Types I-III hepatic injuries can safely be treated conservatively. Complex injuries (types IV and V) result in significant mortality, often requiring operative intervention. Indications of transplantion are uncontrollable hemorrhage or irreversible liver dysfunction. Literature reports describe liver transplantation as a second line treatment of complications following initial treatment. Our patient underwent liver transplantation as a second line treatment. The decision to transplant was based on two pathologic findings, ischemic changes of the liver and sudden cardio-respiratory decompensation following restoration of the blood supply to the liver. Both complications are emergencies, leading to death if not recognized and treated instantly. A total hepatectomy with temporary portocaval shunt followed by liver transplantation immediately or at a later stage is a life saving treatment for such cases.

show abstract

“…Patients who could be managed by other methods of liver repair were excluded; patients with the need for liver packing for bleeding control were enrolled in the study. In the control group, the liver was packed with the conventional method described by Feliciano et al (4). In the case group, the liver was mobilized as much as possible.…”

Section: Methodsmentioning

confidence: 99%

“…Mortality rates of patients with grade IV and V injuries have been estimated to range between 35% and 80% (2,3). Non-operative treatment of the isolated hepatic injury in the stable patient is now considered a standard practice (4)(5). However, various surgical techniques such as packing, anatomic liver resection, and total hepatectomy with liver transplantation can be used to manage unstable patients with liver injury (2,(6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Simple and Safe Packing Method for High-Grade Liver Injuries

Hosseinpour¹,

Asgarzadeh²,

Mohammadzadeh³

et al. 2012

Arch Trauma Res

View full text Add to dashboard Cite

Because of both its ease of use and potential for rapid hemorrhage control, OpSite sheet three-layer pack is introduced for decreasing the complication of pack removal in liver trauma. Background:Injury to the liver is a commonly encountered problem in trauma cases and is a frequent cause of morbidity and mortality. Because gauze packing is easy to use and has the potential for rapid hemorrhage control, it is the most commonly used method for patients with severe liver injuries, particularly those with coagulopathy. Objectives: In this study, OpSite sheets were used to make three-layer packs for decreasing the complication associated with removing gauze packing. Patients and Methods: Twenty male patients with grade IV or V liver injuries that required laparotomy were enrolled in the study. Ten patients were treated using conventional packing, while the other 10 were treated using the three-layer pack. In the case group, the liver was mobilized as much as possible. The three-layer pack was then placed at the site of liver damage and extended onto the liver surface, and the other pads were placed on top of this pad. After 72 h, reoperation was performed, the packs were removed, and the packs causing injury were recorded. Additionally, if rebleeding due to the adhesive bands of the pack was observed, the blood was suctioned and bleeding volume was measured. Data were analyzed using the Mann-Whitney test. Results: Patients in the case and control groups were similar in age and admission vital signs. During the second operation, the bleeding volumes measured in the case and control groups were 66 ± 27.01 mL and 152 ± 85.4 mL, respectively. There was some padinduced damage after the removal of the pad in the control group. Conclusions: Our study has provided a simple and safe packing method for high-grade liver injuries.

show abstract

Hepatic trauma revisited

Cited by 97 publications

References 135 publications

Methylene blue as an antioxidant agent in experimentally-induced injury in rat liver

Methylene blue as an antioxidant agent in experimentally-induced injury in rat liver

Liver Transplantation for Post reperfusion Syndrome due to Surgical Packing of a Lacerated Liver

Simple and Safe Packing Method for High-Grade Liver Injuries

Contact Info

Product

Resources

About