Hdl Handle:
http://hdl.handle.net/10147/207399
Title:
Management of liver trauma.
Authors:
Badger, S A; Barclay, R; Campbell, P; Mole, D J; Diamond, T
Affiliation:
Hepatobiliary Surgical Unit, Mater Hospital, Crumlin Road, Belfast, BT14 6AB, Northern Ireland, UK. Stephen@Badger.tc
Citation:
World J Surg. 2009 Dec;33(12):2522-37.
Journal:
World journal of surgery
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207399
DOI:
10.1007/s00268-009-0215-z
PubMed ID:
19760312
Abstract:
BACKGROUND: Blunt and penetrating liver trauma is common and often presents major diagnostic and management problems. METHODS: A literature review was undertaken to determine the current consensus on investigation and management strategies. RESULTS: The liver is the most frequently injured organ following abdominal trauma. Immediate assessment with ultrasound has replaced diagnostic peritoneal lavage in the resuscitation room, but computerised tomography remains the gold standard investigation. Nonoperative management is preferred in stable patients but laparotomy is indicated in unstable patients. Damage control techniques such as perihepatic packing, hepatotomy plus direct suture, and resectional debridement are recommended. Major complex surgical procedures such as anatomical resection or atriocaval shunting are now thought to be redundant in the emergency setting. Packing is also recommended for the inexperienced surgeon to allow control and stabilisation prior to transfer to a tertiary centre. Interventional radiological techniques are becoming more widely used, particularly in patients who are being managed nonoperatively or have been stabilised by perihepatic packing. CONCLUSIONS: Management of liver injuries has evolved significantly throughout the last two decades. In the absence of other abdominal injuries, operative management can usually be avoided. Patients with more complex injuries or subsequent complications should be transferred to a specialist centre to optimise final outcome.
Language:
eng
MeSH:
Abdominal Injuries/classification/*diagnosis/etiology/*therapy; Humans; Liver/blood supply/*injuries/surgery
ISSN:
1432-2323 (Electronic); 0364-2313 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorBadger, S Aen_GB
dc.contributor.authorBarclay, Ren_GB
dc.contributor.authorCampbell, Pen_GB
dc.contributor.authorMole, D Jen_GB
dc.contributor.authorDiamond, Ten_GB
dc.date.accessioned2012-02-01T10:24:01Z-
dc.date.available2012-02-01T10:24:01Z-
dc.date.issued2012-02-01T10:24:01Z-
dc.identifier.citationWorld J Surg. 2009 Dec;33(12):2522-37.en_GB
dc.identifier.issn1432-2323 (Electronic)en_GB
dc.identifier.issn0364-2313 (Linking)en_GB
dc.identifier.pmid19760312en_GB
dc.identifier.doi10.1007/s00268-009-0215-zen_GB
dc.identifier.urihttp://hdl.handle.net/10147/207399-
dc.description.abstractBACKGROUND: Blunt and penetrating liver trauma is common and often presents major diagnostic and management problems. METHODS: A literature review was undertaken to determine the current consensus on investigation and management strategies. RESULTS: The liver is the most frequently injured organ following abdominal trauma. Immediate assessment with ultrasound has replaced diagnostic peritoneal lavage in the resuscitation room, but computerised tomography remains the gold standard investigation. Nonoperative management is preferred in stable patients but laparotomy is indicated in unstable patients. Damage control techniques such as perihepatic packing, hepatotomy plus direct suture, and resectional debridement are recommended. Major complex surgical procedures such as anatomical resection or atriocaval shunting are now thought to be redundant in the emergency setting. Packing is also recommended for the inexperienced surgeon to allow control and stabilisation prior to transfer to a tertiary centre. Interventional radiological techniques are becoming more widely used, particularly in patients who are being managed nonoperatively or have been stabilised by perihepatic packing. CONCLUSIONS: Management of liver injuries has evolved significantly throughout the last two decades. In the absence of other abdominal injuries, operative management can usually be avoided. Patients with more complex injuries or subsequent complications should be transferred to a specialist centre to optimise final outcome.en_GB
dc.language.isoengen_GB
dc.subject.meshAbdominal Injuries/classification/*diagnosis/etiology/*therapyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshLiver/blood supply/*injuries/surgeryen_GB
dc.titleManagement of liver trauma.en_GB
dc.contributor.departmentHepatobiliary Surgical Unit, Mater Hospital, Crumlin Road, Belfast, BT14 6AB, Northern Ireland, UK. Stephen@Badger.tcen_GB
dc.identifier.journalWorld journal of surgeryen_GB
dc.description.provinceLeinster-

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