Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Liver Trauma: Current Method of Management

Liver Trauma: Current Method of Management Abstract Two hundred eighty-five cases of liver trauma have been treated in the last five years at the San Francisco General Hospital. One hundred three resulted from blunt trauma and 182 from penetrating wounds. The average age was 29 years. Fifty-eight percent of the patients were treated with drainage, 28% by resectional debridement, and 14% by major resection. Associated injuries occurred in 212 patients (74%). Twenty-nine patients (10%) died in the operating room from exsanguination and 23 (9%) postoperatively from head injury, sepsis, and pulmonary insufficiency. The overall mortality was 18.8%. The indications for liver resection in trauma include the following: deep lacerations with involvement of major vascular structure or bile ducts, lacerations which produce nonviable liver segments, and lacerations with massive hemorrhage which are associated with vena cava or hepatic vein injury. References 1. Madding GF, Kennedy PA: Trauma to the Liver . Vol 3 in the series, Major Problems in Clinical Surgery . Philadelphia, WB Saunders Co, 1971. 2. Mays ET: Complex penetrating hepatic wounds . Ann Surg 173:421-428, 1971.Crossref 3. Bricker DL, Morton JR, Okies JE, et al: Surgical management of injuries to the vena cava: Changing patterns of injury and newer techniques of repair . J Trauma 11:725-735, 1971.Crossref 4. Brown RS, Boyd DR, Matsuda T, et al: Temporary internal vascular shunt for retrohepatic vena cava injury . J Trauma 2:736-737, 1971.Crossref 5. David EA, Falk G, Yarnoz M, et al: An improved technique for the repair of the intrahepatic inferior vena cava and hepatic veins . J Trauma 2:738-741, 1971. 6. Schrock T, Blaisdell FW, Mathewson C Jr: Management of blunt trauma to the liver and hepatic veins . Arch Surg 96:698-704, 1968.Crossref 7. Timmis HH, Rosanova AR Jr, Larkin WB: Bloodless hepatic resection with an internal caval shunt . Surgery 65:109-117, 1969. 8. Merendino KA, Dillard DH, Cammock EE: The concept of surgical biliary decompression in the management of liver trauma . Surg Gynec Obstet 117:285-293, 1963. 9. Lucas CE, et al: Biliary drainage in liver trauma . Surg Forum 20:388-390, 1969. 10. Schwartz SI: Surgical Diseases of the Liver . New York, McGraw-Hill Book Co Inc, 1964. 11. Stone HH, Long WD, Smith RB III, et al: Physiologic considerations in major hepatic resections . Amer J Surg 117:78-84, 1969.Crossref 12. Amerson JR, Stone HH: Experiences in the management of hepatic trauma . Arch Surg 100:150-153, 1970.Crossref 13. Lucas CE, Walt AJ: Critical decisions in liver trauma . Arch Surg 101:277-283, 1970.Crossref 14. Pringle JH: Notes on the arrest of hepatic hemorrhage due to trauma . Ann Surg 48:541-549, 1908.Crossref 15. Cafferata HT, Aggeler PM, Robinson AJ, et al: Intravascular coagulation in the surgical patient . Amer J Surg 118:281, 1969.Crossref 16. Schoemaker WC, Van Itallie TB, Walker WF: Measurement of hepatic glucose output and hepatic blood flow in response to glucagon . Amer J Physiol 196:315-318, 1959. 17. Tibblin S, Kock NG, Shenk WG Jr: Central and peripheral circulatory responses to glucagon in hypovolemic dogs . Acta Chir Scand 137:603-611, 1971. 18. Darle N, Kock NG, Lewis D: Liver blood flow in man studied with the Xenonmethod . Bull Soc Int Chir 3:203-207, 1968. 19. Madding GF, Kennedy PA: Effect of glucagon on hepatic blood flow . JAMA 212:482, 1970.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Liver Trauma: Current Method of Management

Lim, Robert C.; Knudson, John; Steele, Muriel
Archives of Surgery , Volume 104 (4) – Apr 1, 1972
Download PDF
7 pages

Loading next page...
 
/lp/american-medical-association/liver-trauma-current-method-of-management-hWNJcQpO0k

References (22)

Publisher
American Medical Association
Copyright
Copyright © 1972 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1972.04180040158027
Publisher site
See Article on Publisher Site

Abstract

Abstract Two hundred eighty-five cases of liver trauma have been treated in the last five years at the San Francisco General Hospital. One hundred three resulted from blunt trauma and 182 from penetrating wounds. The average age was 29 years. Fifty-eight percent of the patients were treated with drainage, 28% by resectional debridement, and 14% by major resection. Associated injuries occurred in 212 patients (74%). Twenty-nine patients (10%) died in the operating room from exsanguination and 23 (9%) postoperatively from head injury, sepsis, and pulmonary insufficiency. The overall mortality was 18.8%. The indications for liver resection in trauma include the following: deep lacerations with involvement of major vascular structure or bile ducts, lacerations which produce nonviable liver segments, and lacerations with massive hemorrhage which are associated with vena cava or hepatic vein injury. References 1. Madding GF, Kennedy PA: Trauma to the Liver . Vol 3 in the series, Major Problems in Clinical Surgery . Philadelphia, WB Saunders Co, 1971. 2. Mays ET: Complex penetrating hepatic wounds . Ann Surg 173:421-428, 1971.Crossref 3. Bricker DL, Morton JR, Okies JE, et al: Surgical management of injuries to the vena cava: Changing patterns of injury and newer techniques of repair . J Trauma 11:725-735, 1971.Crossref 4. Brown RS, Boyd DR, Matsuda T, et al: Temporary internal vascular shunt for retrohepatic vena cava injury . J Trauma 2:736-737, 1971.Crossref 5. David EA, Falk G, Yarnoz M, et al: An improved technique for the repair of the intrahepatic inferior vena cava and hepatic veins . J Trauma 2:738-741, 1971. 6. Schrock T, Blaisdell FW, Mathewson C Jr: Management of blunt trauma to the liver and hepatic veins . Arch Surg 96:698-704, 1968.Crossref 7. Timmis HH, Rosanova AR Jr, Larkin WB: Bloodless hepatic resection with an internal caval shunt . Surgery 65:109-117, 1969. 8. Merendino KA, Dillard DH, Cammock EE: The concept of surgical biliary decompression in the management of liver trauma . Surg Gynec Obstet 117:285-293, 1963. 9. Lucas CE, et al: Biliary drainage in liver trauma . Surg Forum 20:388-390, 1969. 10. Schwartz SI: Surgical Diseases of the Liver . New York, McGraw-Hill Book Co Inc, 1964. 11. Stone HH, Long WD, Smith RB III, et al: Physiologic considerations in major hepatic resections . Amer J Surg 117:78-84, 1969.Crossref 12. Amerson JR, Stone HH: Experiences in the management of hepatic trauma . Arch Surg 100:150-153, 1970.Crossref 13. Lucas CE, Walt AJ: Critical decisions in liver trauma . Arch Surg 101:277-283, 1970.Crossref 14. Pringle JH: Notes on the arrest of hepatic hemorrhage due to trauma . Ann Surg 48:541-549, 1908.Crossref 15. Cafferata HT, Aggeler PM, Robinson AJ, et al: Intravascular coagulation in the surgical patient . Amer J Surg 118:281, 1969.Crossref 16. Schoemaker WC, Van Itallie TB, Walker WF: Measurement of hepatic glucose output and hepatic blood flow in response to glucagon . Amer J Physiol 196:315-318, 1959. 17. Tibblin S, Kock NG, Shenk WG Jr: Central and peripheral circulatory responses to glucagon in hypovolemic dogs . Acta Chir Scand 137:603-611, 1971. 18. Darle N, Kock NG, Lewis D: Liver blood flow in man studied with the Xenonmethod . Bull Soc Int Chir 3:203-207, 1968. 19. Madding GF, Kennedy PA: Effect of glucagon on hepatic blood flow . JAMA 212:482, 1970.Crossref

Journal

Archives of Surgery – American Medical Association

Published: Apr 1, 1972

There are no references for this article.