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DOI: 10.1055/s-0041-1724014
Hepatic Trauma Interventions
Abstract
The liver is the second most commonly involved solid organ (after spleen) to be injured in blunt abdominal trauma, but liver injury is the most common cause of death in such trauma. In patients with significant blunt abdominal injury, the liver is involved approximately 35 to 45% of the time. Its large size also makes it a vulnerable organ, commonly injured in penetrating trauma. Other than its position and size, the liver is surrounded by fragile parenchyma and its location under the diaphragm makes it vulnerable to shear forces during deceleration injuries. The liver is also a vascular organ made of large, thin-walled vessels with high blood flow. In severe hepatic trauma, hemorrhage is a common complication and uncontrolled bleeding is usually fatal. In fact, in patients with severe abdominal trauma, liver injury is the primary cause of death. This article reviews the clinical presentation of patients with liver injury, the grading system for such injuries that is most frequently used, and management of the patient with liver trauma.
Publication History
Article published online:
15 April 2021
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References
- 1 Feliciano DV, Rozycki GS. Hepatic trauma. Scand J Surg 2002; 91 (01) 72-79
- 2 Taghavi S, Askari R. Liver Trauma. Treasure Island, FL: StatPearls; 2020
- 3 Padia SA, Ingraham CR, Moriarty JM. et al. Society of Interventional Radiology Position Statement on endovascular intervention for trauma. J Vasc Interv Radiol 2020; 31 (03) 363-369.e2 , e2
- 4 Kozar RA, Crandall M, Shanmuganathan K. et al; AAST Patient Assessment Committee. Organ injury scaling 2018 update: spleen, liver, and kidney. J Trauma Acute Care Surg 2018; 85 (06) 1119-1122
- 5 Ruscelli P, Gemini A, Rimini M. et al. The role of grade of injury in non-operative management of blunt hepatic and splenic trauma: case series from a multicenter experience. Medicine (Baltimore) 2019; 98 (35) e16746
- 6 Letoublon C, Amariutei A, Taton N. et al. Management of blunt hepatic trauma. J Visc Surg 2016; 153 (4, Suppl): 33-43
- 7 Tarchouli M, Elabsi M, Njoumi N, Essarghini M, Echarrab M, Chkoff MR. Liver trauma: What current management?. Hepatobiliary Pancreat Dis Int 2018; 17 (01) 39-44
- 8 Virdis F, Reccia I, Di Saverio S. et al. Clinical outcomes of primary arterial embolization in severe hepatic trauma: a systematic review. Diagn Interv Imaging 2019; 100 (02) 65-75
- 9 Kalil M, Amaral IM. Epidemiological evaluation of hepatic trauma victims undergoing surgery. Rev Col Bras Cir 2016; 43 (01) 22-27