Liver Trauma - Operative Management

Morrison, Jonathan J.; Bramley, KE; Ag, Rizzo

doi:10.1136/jramc-157-02-03

Cited by 18 publications

(10 citation statements)

References 81 publications

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“…Diagnosis and treatment of hepatic trauma has evolved with the use of modern diagnostic and therapeutic tools [2][3][4]. Until two to three decades ago, most cases with blunt abdominal trauma and possible injury in parenchymatous organs were managed by exploratory laparotomy [5]. Several innovative multimodal approaches as EVTM (endovascular trauma and bleeding management) have allowed to greatly increase the likelihood of nonoperative management (NOM) for selected patients.…”

Section: Introductionmentioning

confidence: 99%

Liver trauma: WSES 2020 guidelines

et al. 2020

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Liver injuries represent one of the most frequent life-threatening injuries in trauma patients. In determining the optimal management strategy, the anatomic injury, the hemodynamic status, and the associated injuries should be taken into consideration. Liver trauma approach may require non-operative or operative management with the intent to restore the homeostasis and the normal physiology. The management of liver trauma should be multidisciplinary including trauma surgeons, interventional radiologists, and emergency and ICU physicians. The aim of this paper is to present the World Society of Emergency Surgery (WSES) liver trauma management guidelines.

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Section: Introductionmentioning

confidence: 99%

Liver trauma: WSES 2020 guidelines

et al. 2020

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“…The most common treatment strategy employed for solid organ injuries in blunt abdominal trauma was surgical intervention until approximately 30 years ago. 16 -19 In recent years, there has been a shift from surgical to NOM of solid organ trauma, particularly in cases of blunt injury. 20,21 This shift to conservative approaches has been, in part, a consequence of parallel improvements in intensive care, accuracy of diagnostic imaging, and advancements in interventional radiology techniques.…”

Section: Nonoperative Management Of Solid Organ Traumamentioning

confidence: 99%

Changes in Approach to Solid Organ Injury: What the Radiologist Needs to Know

et al. 2020

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This review aims to examine the challenges facing radiologists interpreting trauma computed tomography (CT) images in this era of a changing approach to management of solid organ trauma. After reviewing the pearls and pitfalls of CT imaging protocols for detection of traumatic solid organ injuries, we describe the key changes in the 2018 American Association for the Surgery of Trauma Organ Injury Scales for liver, spleen, and kidney and their implications for management strategies. We then focus on the important imaging findings in observed in patients who undergo nonoperative management and patients who are imaged post damage control surgery.

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“…Over the last century, the management of liver trauma has swung between the operative and non-operative approaches more than once, but in the last three decades there has been a growing appreciation of the important role of selective non-operative management (SNOM) with improving outcomes [4], although controversy still exists in certain areas [5]. Morrison et al [6] have recently reviewed in this journal the operative strategies available to the clinician dealing with the injured liver and this article reviews the evidence supporting SNOM of hepatic trauma.…”

Section: Introductionmentioning

confidence: 99%

Non-Operative Management of Liver Trauma

Swift

Garner

2012

J R Army Med Corps

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The liver is one of the commonest intra-abdominal organs injured worldwide in blunt and penetrating trauma and its management has evolved significantly in the last 30 years. Mandatory laparotomy has been replaced by an acceptance that for most blunt hepatic trauma, a selective non-operative approach is safe and effective with a failure rate ie the need to proceed to delayed laparotomy of approximately 10%. There is a markedly lower rate of complications in those that are managed non-operatively. Adjuncts to this conservative regimen such as angioembolisation and delayed laparoscopy to treat biliary peritonitis increase the chances of avoiding laparotomy. This belief in non-operative management has also been transferred to some degree to penetrating liver trauma, where there is a gradual accumulation of evidence to support this non-operative approach in a carefully selected group of patients. This article examines the evidence supporting the selective non-operative management of both blunt and penetrating liver trauma and describes the outcomes and complications.

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Liver Trauma - Operative Management

Cited by 18 publications

References 81 publications

Liver trauma: WSES 2020 guidelines

Liver trauma: WSES 2020 guidelines

Changes in Approach to Solid Organ Injury: What the Radiologist Needs to Know

Non-Operative Management of Liver Trauma

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