Jurnalul de Chirurgie
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Aparitie trimestriala in a doua luna a trimestrului
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ISSN: 1584 - 9341 Vol.10 Nr.3 - Iulie-Septembrie 2014 | sâmbătă, 23 martie 2019
ISSN: 1584 - 9341 Vol.10 No.3 - July-September 2014
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NUMARUL 3, VOL. 1, 2005

ARTICOLE DE SINTEZA - REVIEW

LIVER CONTUSIONS: INDICATIONS FOR NON OPERATIVE APPROACH
C. Létoublon, Catherine Arvieux

Department of Digestive and General Surgery
C.H.U. "A. Michallon", Grenoble, France
Jurnalul de chirurgie 2005; 1 (3):250-259
Full text: Format PDF (French)

Abstract:

The most important condition for a conservative treatment of the liver trauma is a stable patient. Ultrasound and computerized tomography (CT) examinations are essential for the investigation of abdominal trauma. These explorations allow visualization of solid organ anatomy and have the ability to grade and quantify the livers' injuries (Mirvis classification). After the first exploration and the decision for initial non-operative approach, the patients will be followed in the intensive care unit (hemodynamic status, biological exploration, CT or ultrasonography). In this second survey period it is possible to appear complications (hemorrhage, peritonitis, intra-abdominal hyper-pressure syndrome etc.) and emergency laparotomy can be necessary. The overall mortality for non operative approach is about 9%, and direct mortality is under 1%. Secondary operations are necessary in 7-10% from these patients. Interventional radiology techniques and endoscopic procedures (such as endoscopic retrograde cholangio-pancreatography) allowed the reduction of the secondary surgical interventions. Hospital stay depends by the grade of the liver injury. Long term follow-up it is necessary; some cystic image can appear in the liver parenchyma at CT exam after months or years from the trauma, but without clinical significance.

KEYWORDS: LIVER TRAUMA, NON-OPERATIVE APPROACH, LAPAROTOMY



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Jurnalul de chirurgie [Journal of Surgery] by Editorial Board, Department of Surgery University of Medicine and Pharmacy Iasi, E. Tarcoveanu, R. Moldovanu is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at www.jurnaluldechirurgie.ro.