MANAGEMENT OF TRAUMATIC LIVER LESIONS

Authors

  • D. TIMOFTE University of Medicine and Pharmacy "Grigore T. Popa" – Iasi
  • I. HUTANU Regional Institute of Oncology, Iasi
  • Roxana Maria LIVADARIU University of Medicine and Pharmacy "Grigore T. Popa" – Iasi
  • R.P. SOROCEANU University of Medicine and Pharmacy "Grigore T. Popa" – Iasi
  • Iulia MUNTEANU University of Medicine and Pharmacy "Grigore T. Popa" – Iasi
  • C. DIACONU University of Medicine and Pharmacy "Grigore T. Popa" – Iasi
  • Lidia IONESCU University of Medicine and Pharmacy "Grigore T. Popa" – Iasi

Abstract

Aim: To determine the correct therapeutic approach to the different grades of liver trauma. Material and methods: The study is based on a retrospective analysis of treatment outcomes in 56 patients with abdominal trauma admitted over a 9-year period to in the IIIrd Surgical Clinic of the Iasi “Sf. Spiridon” Hospital. It is focused on operative or non-operative management of liver trauma, surgical technique used, morbidity and postoperative mortality. Data were collected from electronic medical records and observation sheets and processed and interpreted using Microsoft Excel statistical functions. Results: In the interval May 26, 2005 – April 19, 2013 56 cases of abdominal trauma were recorded, 31 (55.35%) residing in urban areas, and 25 (44.64%) in rural areas. The mean age was 39 years, range 18-83 years old. The male/female ratio was 2.5/1 and the group consisted of 40 (71.42%) male patients and 16 (28.57%) female patients. The causes of abdominal trauma were: car accident in 29 (51%) cases, fall from different heights in 6 (10%) patients, workplace-related accidents in 8 patients (14%) and direct hit injury in 12 patients (12%). In our cohort, 51 (91%) patients with abdominal trauma have been emergency admitted, 3 patients (5%) were transferred from different medical units, and 2 patients (4%) were referred by a specialist doctor. Two or more simultaneous lesions were diagnosed in 53 (96%) cases. Of the 45 patients with traumatic liver injuries diagnosed on admission, 32 (71%) required surgical intervention. In the remaining 13 (29%) patients, the therapeutic management was conservative. Conclusions: Hepatic traumas are often severe, and frequently associated with multiple injuries. The non-operative management is indicated in liver lesions grade I, II and III according to the American Association for the Surgery of Trauma (AAST), if abdominal cavity organs are not injured. Higher grade liver lesions (over IV) in which the hemorrhagic risk persists or reappears require surgical intervention as soon as possible, and according to the type of lesion, the right procedure should be chosen.

Author Biographies

  • D. TIMOFTE, University of Medicine and Pharmacy "Grigore T. Popa" – Iasi

    Faculty of Medicine
    Department of Surgery

  • Roxana Maria LIVADARIU, University of Medicine and Pharmacy "Grigore T. Popa" – Iasi

    Faculty of Medicine
    Department of Surgery

  • R.P. SOROCEANU, University of Medicine and Pharmacy "Grigore T. Popa" – Iasi

    Faculty of Medicine
    Department of Surgery

  • Iulia MUNTEANU, University of Medicine and Pharmacy "Grigore T. Popa" – Iasi

    Faculty of Medicine
    Department of Surgery

  • C. DIACONU, University of Medicine and Pharmacy "Grigore T. Popa" – Iasi

    Faculty of Medicine
    Department of Surgery

  • Lidia IONESCU, University of Medicine and Pharmacy "Grigore T. Popa" – Iasi

    Faculty of Medicine
    Department of Surgery

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Additional Files

Published

2015-06-30

Issue

Vol. 119 No. 2 (2015): The Medical-Surgical Journal

Section

SURGERY

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