WSES classification and guidelines for liver trauma

Catena, Fausto; Catena, Fausto; Moore, Ernest E.; Ivatury, Rao R.; Biffl, Walter L.; Peitzman, Andrew B.; Coimbra, Raúl; Rizoli, Sandro; Kluger, Yoram; Abu‐Zidan, Fikri M.; Ceresoli, Marco; Montori, Giulia; Sartelli, Massimo; Weber, Dieter; Fraga, Gustavo Pereira; Naidoo, Noel; Moore, Frederick A.; Zanini, Nicola; Ansaloni, Luca

doi:10.1186/s13017-016-0105-2

Cited by 159 publications

(155 citation statements)

References 53 publications

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“…Successful laparoscopic management of retained hemoperitoneum, infective perihepatic collections, and treatment of bile peritonitis after severe hepatic trauma initially treated by NOM have been described [61, 62] and are recommended by several guidelines [8, 9, 63]. These interventions are usually necessary 3 to 5 days post-injury [62, 64].…”

Section: For Whom?mentioning

confidence: 99%

Laparoscopy in Blunt Abdominal Trauma: for Whom? When?and Why?

2017

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The management of blunt abdominal trauma has evolved over time. While laparotomy is the standard of care in hemodynamically unstable patients, stable patients are usually treated by non-operative management (NOM), incorporating adjuncts such as interventional radiology. However, although NOM has shown good results in solid organ injuries, other lesions, namely those involving the hollow viscus, diaphragm, and mesentery, do not qualify for this approach and need surgical exploration. Laparoscopy can substantially reduce additional surgical aggression. It has both diagnostic and therapeutic potential and, when negative, may reduce the number of unnecessary laparotomies. Although some studies have shown promising results on the use of laparoscopy in blunt abdominal trauma, randomized controlled studies are lacking. Laparoscopy requires adequate training and experience as well as sufficient staffing and equipment.

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Section: For Whom?mentioning

confidence: 99%

Laparoscopy in Blunt Abdominal Trauma: for Whom? When?and Why?

2017

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“…Current recommendations for managing adult hepatic trauma are supported by the World Society of Emergency Surgery (WSES) 2016 classification of liver injury. 15 Most recent guidelines stratify liver injury according to the WSES classification scheme, which utilizes the AAST grading and takes hemodynamic stability into account. For the hemodynamically stable patient with AAST grade I-IV, NOM is the most evidence-based treatment.…”

Section: Overview Of Management Of Hepatic Trauma In Adultsmentioning

confidence: 99%

Contemporary Management of Hepatic Trauma: What IRs Need to Know

Gilyard

Shinn

Nezami

et al. 2020

Semin intervent Radiol

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Trauma remains one of the leading causes of death in the United States in patients younger than 45 years. Blunt trauma is most commonly a result of high-speed motor vehicular collisions or high-level fall. The liver and spleen are the most commonly injured organs, with the liver being the most commonly injured organ in adults and the spleen being the most affected in pediatric blunt trauma. Liver injuries incur a high level of morbidity and mortality mostly secondary to hemorrhage. Over the past 20 years, angiographic intervention has become a mainstay of treatment of hepatic trauma. As there is an increasing need for the interventional radiologists to embolize active hemorrhage in the setting of blunt and penetrating hepatic trauma, this article aims to review the current level of evidence and contemporary management of hepatic trauma from the perspective of interventional radiologists. Embolization techniques and associated outcome and complications are also reviewed.

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“…The necessity to follow the modern possibilities of treatment imposes addressing trauma using a classification based on anatomical lesions and on the physiological status of the patient [4–6]. …”

Section: Dear Editormentioning

confidence: 99%

“…The WSES classification divides hepatic injuries into three degrees considering the AAST-OIS classification and the hemodynamic status (Table 1) [4]:Minor (WSES class I)Moderate (WSES class II)Severe (WSES class III and IV)…”

Section: Liver Injuriesmentioning

confidence: 99%

Abdominopelvic trauma: from anatomical to anatomo-physiological classification

Catena

Catena²,

Kluger

et al. 2018

World J Emerg Surg

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Abdominopelvic trauma has been for decades classified with the AAST-OIS (American Association for the Surgery of Trauma—Organ Injury Scale) classification. It has represented a milestone. At present, the medical evolutions in trauma management allowed an incredible progress in trauma decision-making and treatment. Non-operative trauma management has been widely applied. The interventional radiological procedures and the modern conception of Hybrid and Endovascular Trauma and Bleeding Management (EVTM) led to good results in increasing the rate of patients managed non-operatively, opening new scenarios and options. Even severe anatomical lesions in hemodynamically stable patients can be safely managed non-operatively. The driving issue in deciding for the best treatment is anatomy, as well as physiology, for the patient physiological derangement grade is even more important. The emergency general surgeon must be prepared in those pathophysiological issues that play the pivotal role in the team management of trauma patients. Moreover, the classification of trauma patients cannot only remain anchored to anatomical lesions. The necessity to follow the modern possibilities of treatment imposes addressing trauma using a classification based on anatomical lesions and on the physiological status of the patient.

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WSES classification and guidelines for liver trauma

Cited by 159 publications

References 53 publications

Laparoscopy in Blunt Abdominal Trauma: for Whom? When?and Why?

Laparoscopy in Blunt Abdominal Trauma: for Whom? When?and Why?

Contemporary Management of Hepatic Trauma: What IRs Need to Know

Abdominopelvic trauma: from anatomical to anatomo-physiological classification

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