Our Experience of Nonoperative Management in Patients with Liver Injury Due to Multiple Blunt Trauma

Yıldırım, Mehmet Aykut; Vatansev, Hülya; Şentürk, Mustafa; Kadıyoran, Cengiz; İyisoy, Mehmet Sinan

doi:10.30733/std.2020.01398

Cited by 1 publication

(3 citation statements)

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“…Additionally, this study demonstrated the majority of our patients had associated injuries, with thoracic being the most common, followed by orthopedic and head injuries. Other studies have reported similar findings, with one study showing thoracic injuries as the most prevalent associated injury, followed by extremity and head trauma [19]. Another study focusing on surgically treated patients with liver injury observed that musculoskeletal injuries are the most frequent, followed closely by thoracic injuries [20].…”

Section: Discussionmentioning

confidence: 61%

“…NOM is generally considered the standard of care for blunt liver trauma, with >95% of these injuries being non-surgically managed at a success rate of 80-100% [18]. However, the major determinants of the NOM approach are hemodynamic stability and absence of peritoneal irritation or other internal injuries requiring surgery, irrespective of the initial injury grade [11,19,21]. Implementing these strict inclusion criteria for NOM has yielded remarkable improvements in patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, a prospective Saudi study by Ghnnam et al [24] that evaluated liver trauma patients over four years revealed that conservative management had a success rate of 100%. Additionally, Yildirim et al [19] retrospectively analyzed NOM in 104 patients with liver injuries. The study showed that the NOM was successful in 94 patients, whereas surgical management was performed in 10 patients in whom NOM failed.…”

Section: Discussionmentioning

confidence: 99%

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Management and Outcomes of Traumatic Liver Injury: A Retrospective Analysis from a Tertiary Care Center Experience

Alanezi,

Altoijry,

Alanazi

et al. 2024

Healthcare

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Background: although liver injuries are one of the most critical complications of abdominal trauma, choosing when to operate on these injuries is challenging for surgeons worldwide. Methods: We conducted a retrospective analysis of liver injury cases at our institution from 2016 to 2022 to describe the operative and nonoperative management (NOM) outcomes in patients with traumatic liver injuries. Baseline patient characteristics, liver injury details, treatments, and outcomes were analyzed. Results: Data from 45 patients (male, 77.8%) were analyzed. The mean age was 29.3 years. Blunt trauma was the most common injury mechanism (86.7%), whereas penetrating injuries were 8.9% of cases. Conservative management was associated with 18.9% of complications. The overall complication rate was 26.7%; delirium and sepsis were the most common (13.3%), followed by acute renal failure (4.4%), pneumonia, biliary leaks, and meningitis/seizures. Conclusions: Notwithstanding its limitations, this retrospective analysis demonstrated that NOM can serve as a safe and effective strategy for hemodynamically stable patients with liver trauma, irrespective of the patient’s injury grade. Nevertheless, careful patient selection and monitoring are crucial. Further investigations are necessary to thoroughly evaluate the management of traumatic liver injuries, particularly in the context of multiorgan injuries.

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Section: Discussionmentioning

confidence: 61%