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Early right hepatectomy for severe liver trauma: a case report
N Guglielmo1, F Melandro1, L Improta1
1Departments "Paride Stefanini", General Surgery and Organ Transplant, Sapienza University of Rome, Italy.
La Clinica Terapeutica
|May 7, 2015
Summary
Blunt abdominal trauma can cause severe liver injuries. Early right hepatectomy (liver resection) is a life-saving option for hemodynamically unstable patients with high-grade liver injuries when conservative management fails.
Area of Science:
- Trauma Surgery
- Hepatobiliary Surgery
- Emergency Medicine
Background:
- Blunt abdominal trauma frequently involves liver injury.
- Nonoperative management has reduced mortality for blunt hepatic trauma over three decades.
- Surgery remains critical for hemodynamically unstable patients with severe liver injuries.
Observation:
- A 16-year-old male sustained a grade V liver injury from blunt abdominal trauma during a football accident.
- The patient initially underwent liver packing followed by an early right hepatectomy.
- This intervention was crucial to halt clinical deterioration.
Findings:
- High-grade liver injuries necessitate surgical intervention for bleeding control and necrotic tissue removal.
- Liver resection (hepatectomy) effectively manages severe bleeding and prevents complications like bile leaks.
- Prompt hepatectomy by experienced surgeons can be life-saving in deteriorating patients.
Implications:
- Early hepatectomy is a viable and potentially life-saving strategy for severe blunt liver trauma.
- This case highlights the importance of surgical expertise in managing complex hepatic injuries.
- Aggressive surgical management may be required when nonoperative approaches are insufficient.
