Management of liver trauma

Parks, Rowan W.; Chrysos, Emmanuel; Diamond, Tom

doi:10.1046/j.1365-2168.1999.01210.x

Cited by 166 publications

(197 citation statements)

References 124 publications

(157 reference statements)

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“…Lipid peroxidation parameters did not alter due to devascularization or due to MB treatment. ALT Liver injury may lead to death as a result of uncontrolled bleeding or sepsis (5,20). Non-operative management of stable liver trauma patients is associated with reduced mortality (21,22).…”

Section: Discussionmentioning

confidence: 99%

“…Devascularization injury is a life-threatening form of liver injury resulting from disrupted vascular infl ow to one or more hepatic segments (5). It is important to be able to diagnose this type of injury, since stable patients may develop decompensation due to septic complications.…”

Section: Introductionmentioning

confidence: 99%

“…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%

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

Bozkurt¹,

Dumlu²,

Tokaç³

et al. 2015

BLL

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Bozkurt¹,

Dumlu²,

Tokaç³

et al. 2015

BLL

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Section: Introductionmentioning

confidence: 99%

“…Though liver is the second most commonly injured organ in abdominal trauma; it is the most common cause of death following abdominal injury. Compared to splenic injuries, management of liver trauma still remains a challenge in the best of trauma centres [1,2].In the past, most liver injuries were treated surgically. However evidence confirms that about 86% of liver injuries have stopped bleeding by the time surgical exploration is performed and 67% of laparotomies done for blunt trauma abdomen are non-therapeutic.…”

mentioning

confidence: 99%

Blunt Trauma Liver-Conservative or Surgical Management: A Retrospective Study

Pn¹,

Ts²,

Anantharaj³

2012

J Trauma Treat

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IntroductionThe relatively fixed position of the liver and its large size makes it more prone for injury in blunt trauma of the abdomen. Liver and spleen together, account for 75% of injuries in blunt abdominal trauma. Though liver is the second most commonly injured organ in abdominal trauma; it is the most common cause of death following abdominal injury. Compared to splenic injuries, management of liver trauma still remains a challenge in the best of trauma centres [1,2].In the past, most liver injuries were treated surgically. However evidence confirms that about 86% of liver injuries have stopped bleeding by the time surgical exploration is performed and 67% of laparotomies done for blunt trauma abdomen are non-therapeutic. Imaging techniques especially Computerised Tomographic (CT) scan has created remarkable impact in managing liver trauma patients by reducing the number of laparotomies. About 80% of adults and 97% of children are presently managed conservatively worldwide at high volume trauma centres [3,4].The large size of the liver, the friable parenchyma, its thin capsule and its relatively fixed position make it prone to blunt injury. Right lobe is more often involved, owing to its larger size and proximity to the ribs [5,6]. Compression against the fixed ribs, spine or posterior abdominal wall results in predominant damage to segments 6, 7 and 8 of the liver (>85%). Pressure on right hemithorax may propagate through the diaphragm producing contusion of dome of right lobe of liver. Liver's ligamentous attachments to diaphragm and posterior abdominal wall act as sites of shearing forces during deceleration injury. Liver injury can also occur as a result of transmission of excessively high venous pressure to remote body sites at the time of impact. Weaker connective tissue framework, relatively large size and incomplete maturation and more flexible ribs account for higher chance of liver injury in children compared to adults.Deceleration injuries producing shearing forces may tear hepatic lobes and often involve the inferior vena cava and hepatic veins. A steering column injury can damage an entire lobe. Liver trauma may result in subcapsular/intrahepatic hematomas, lacerations, contusions, hepatic vascular injury and bile duct injury. Most blunt trauma livers (80% in adults and 97% in children) are treated conservatively [7,8].Conservative treatment mandates repeated clinical monitoring and surgical intervention if conservative treatment fails. A comparison of patients receiving operative and nonoperative treatment of liver Abstract Background: The liver is one of the most frequently damaged organs and remains the most common cause of death following blunt abdominal trauma. Currently, a conservative management constitutes the treatment of choice in patients with hemodynamic stability. The aim of this study is to evaluate the results of an operative and conservative management of 55 patients with liver injury treated in a single institution.

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