EVALUATION & MANAGEMENT OF PATIENTS WITH LIVER TRAUMA.

Autor: TALPUR, ALTAF AHMED, AWAN, MOHAMMAD SHARIF, HASHMI, FAZILA, JAMAL, AKMAL
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Zdroj: Medical Channel; Jul-Sep2013, Vol. 19 Issue 3, p39-43, 5p
Abstrakt: Background: Liver trauma is one of the commonest surgical emergencies dealt by general surgeons worldwide. The incidence of liver trauma has increased recently due to more road traffic accidents & more violence in the community. It is associated with significant morbidity & mortality. It required well defined & well designed protocols to identify liver injury & treat it accordingly at the earliest. Materials & Methods: A prospective, descriptive study conducted at surgical ward of Liaquat university Hospital, Hyderabad, Pakistan from Jan 2009 to Dec 2012. All patients of either sex above the age of 12 years who presented with trauma to lower chest & abdomen & clinically as well as on investigations or at operation found to have liver injuries were included in the study. Variable studied in this study were age, sex, pattern of trauma, Grading of liver injuries, associated injuries to other structures, treatment applied & post treatment complications. Results: Total 103 patients with liver injuries were evaluated. Mean age was 27.35 years with SD ± 12.23 (14-67 years) with male to female ratio of 5.18: 1. RTA was the commonest cause of Liver trauma in 74 patients. 20(19.41%) of blunt trauma & 16(15.53%) patients of penetrating injury presented in profound hypotension & were directly transferred to OR & operated. Findings were grade IV & V liver injuries in 15 patients. 21 unstable patients had Grade I to III liver injuries. Associated injuries to other viscera were found in all these patients. Remaining 57(55.33%) patients of blunt trauma & 10(9.7%) patients of penetrating injury were admitted & investigated. C.T scan Abdomen was performed in 57 (55.33%) patients. 21 patients were managed conservatively & recovered. Remaining 36 patients were operated. Postoperatively 26(25.24%) developed complications. 07(6.79%) died. Conclusion: Liver trauma is a commonly found condition in younger age group which carries significant morbidity & mortality. It is most commonly due to RTA. It can be effectively managed if these patients are properly evaluated. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index