Management of liver trauma in cirrhotics

Abstract

Liver cirrhosis is the tenth leading cause of death[!). Although cirrhosis-related deaths have decreased over the years, the impact of cirrhosis remains with approximately [2]. Cirrhotic patients often suffer from complications Cirrhosis impairs nutrition, alters response to stress, and affects the functions of other organ systems.[3]

Trauma, in combination with cirrhosis in patients, brings about a unique challenge. Surgeons in trauma centers treat a variety of patients every day, but treatment of traumatized cirrhotic patients remains a challenge[4).

It has been shown that the mortality and morbidity rates increase in patients with cirrhosis undergoing elective or emergency surgery[5). Also the degree of hepatic insufficiency is a prime factor for determining the outcome

in these patients[6]

Adequate hepatic function is necessary in physiological response to surgery or traumatic injury[?]. The liver plays a vital role in protein synthesis, detoxifi cation, and immune responses. In a patient subjected to surgical intervention for traumatic injury, any degree of hepatic insufficiency would diminish the liver's ability to carry out these vital metabolic functions[S). Because of impaired cirrhotic reserves, a surgical or trauma cirrhotic patient would be at a great risk of developing complications and death may occur during the recovery period[9).

liver insufficiency was positively associated with a poorer outcome. The lower survival and increased complication rates of cirrhotic trauma