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Published on: November 27, 2019
Hepatic injury
Luis Donizeti da Silva Stracieri1, Sandro Scarpelini
1Division of Gastroenterology, Department of Surgery and Anatomy, FMRP, USP, Brazil. stracieri@directnet.com.br
Acta Cirurgica Brasileira
|October 3, 2006
Summary
Hepatic trauma, a common emergency room admission, is effectively diagnosed using imaging like CT scans. Management strategies range from nonoperative care for stable blunt injuries to surgical interventions for severe liver trauma.
Area of Science:
- Trauma Surgery
- Abdominal Injury Management
Background:
- Hepatic trauma accounts for 5% of emergency room admissions, with the liver's anatomy predisposing it to injury, especially penetrating trauma.
- The American Association for the Surgery of Trauma (AAST) developed a classification system for uniform hepatic injury assessment.
Purpose of the Study:
- To review diagnostic modalities and management strategies for hepatic trauma.
- To highlight the evolution of treatment from operative to nonoperative approaches for specific injury types.
Main Methods:
- Review of diagnostic tools including diagnostic peritoneal lavage, ultrasound, and computed tomography (CT).
- Discussion of management principles for blunt and penetrating hepatic injuries.
- Overview of surgical techniques for minor and major liver trauma, including damage control.
Main Results:
- Advanced imaging (CT) enables faster, more accurate diagnosis of liver injuries.
- Nonoperative management is the standard for hemodynamically stable patients with blunt hepatic trauma.
- Surgical options for major liver injuries include repair, resection, packing, and damage control strategies.
Conclusions:
- Accurate diagnosis and tailored management, including nonoperative approaches and damage control surgery, are crucial for improving outcomes in hepatic trauma.
- While minor injuries may require simple repair, major liver trauma remains a significant surgical challenge necessitating advanced techniques.
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