UPDATES IN Hepato-Biliary Injuries
Mahmoud Saad Ibrahim El-Shenawy;
Abstract
The liver is the second most commonly injured organ in
abdominal trauma, but liver damage is the most common cause of death after abdominal injury. Although urgent surgery continues to be the standard for hemodynamically compromised patients with hepatic trauma, there has been a paradigm shift in the management of patients who have stable hemodynamic. A marked change toward a more conservative approach in the treatment of abdominal trauma has been noted during the last decades. Modern treatment of liver trauma is increasingly non-operative.
Road traffic accident, antisocial violent behaviors, industrial and farming accidents are the commonest mode of injury to the liver. Though the liver is protected by the rib cage, as the largest solid organ in the abdomen, the liver is particularly vulnerable to the ability of compressive abdominal blows to rupture its relatively thin capsule.
Approximately 5% of trauma patients admitted to the hospital have a liver trauma. Traffic accidents are the most common mechanism of injury. 74% are blunt hepatic trauma
and 17% are classified as severe as, greater than grade III of American Association for the Surgery of Trauma (AAST). Mortality in hepatic trauma is currently between 4 and 15% and depends on the severity of liver injury and other associated injuries.
Bile duct injury is a catastrophic complication and adds significantly to the morbidity of the patients; therefore early detection is mandatory to avoid as much complication as possible. The incidence of biliary injuries after cholecystectomy might be kept down by understanding the exact anatomical knowledge with its variants, meticulous surgical dissection technique, intraoperative cholangiography and early consideration of conversion to open technique.
abdominal trauma, but liver damage is the most common cause of death after abdominal injury. Although urgent surgery continues to be the standard for hemodynamically compromised patients with hepatic trauma, there has been a paradigm shift in the management of patients who have stable hemodynamic. A marked change toward a more conservative approach in the treatment of abdominal trauma has been noted during the last decades. Modern treatment of liver trauma is increasingly non-operative.
Road traffic accident, antisocial violent behaviors, industrial and farming accidents are the commonest mode of injury to the liver. Though the liver is protected by the rib cage, as the largest solid organ in the abdomen, the liver is particularly vulnerable to the ability of compressive abdominal blows to rupture its relatively thin capsule.
Approximately 5% of trauma patients admitted to the hospital have a liver trauma. Traffic accidents are the most common mechanism of injury. 74% are blunt hepatic trauma
and 17% are classified as severe as, greater than grade III of American Association for the Surgery of Trauma (AAST). Mortality in hepatic trauma is currently between 4 and 15% and depends on the severity of liver injury and other associated injuries.
Bile duct injury is a catastrophic complication and adds significantly to the morbidity of the patients; therefore early detection is mandatory to avoid as much complication as possible. The incidence of biliary injuries after cholecystectomy might be kept down by understanding the exact anatomical knowledge with its variants, meticulous surgical dissection technique, intraoperative cholangiography and early consideration of conversion to open technique.
Other data
| Title | UPDATES IN Hepato-Biliary Injuries | Other Titles | الجديد في إصابات الكبد و القنوات المرارية | Authors | Mahmoud Saad Ibrahim El-Shenawy | Issue Date | 2017 |
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