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Published in: Indian Journal of Surgery 6/2016

01-12-2016 | Original Article

Management of Liver Trauma in Minia University Hospital, Egypt

Authors: Abdel Fattah Saleh, Emad Al.Sageer, Amr Elheny

Published in: Indian Journal of Surgery | Issue 6/2016

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Abstract

The aim of this study is to present the outcome of operative and non-operative management of patients with liver injury treated in a single institution depending on imaging. This study was conducted at the Causality Unit of Minia University Hospital, and included 60 patients with hepatic trauma from March 2012 to January 2013. In our study, males represent 80 % while females represent 20 % of the traumatized patients. The peak age for trauma found was 11–30 years. Blunt trauma is the most common cause of liver injury as it was the cause in 48 patients (80 %). Firearm injuries are the most common cause of penetrating trauma (60 %) followed by stab injuries (40 %). More than one half of our patients (34 out of 60) were treated with non-operative management (NOM) with a high success rate. The operative procedures done were suture hepatorrhaphy (20 cases), non-anatomical resection in one case, anatomical resection in one case, and damage control therapy using pads in two cases. In another two cases, nothing was done as subcapsular hematoma had resolved. Minia University Hospital is a big tertiary Hospital in Egypt at which blunt liver trauma is more common than penetrating liver trauma. Surgery is no longer the only option available. It has been reserved for extensive lesions with condition of hemodynamic instability or for the treatment of the complications. NOM is an effective treatment modality in most cases.
Literature
1.
go back to reference Helling TS, Ward MR, Balon J (2009) Is the grading of liver injuries a useful clinical tool in the initial management of blunt trauma patients? Eur J Trauma Emerg Surg 35:95–101CrossRefPubMed Helling TS, Ward MR, Balon J (2009) Is the grading of liver injuries a useful clinical tool in the initial management of blunt trauma patients? Eur J Trauma Emerg Surg 35:95–101CrossRefPubMed
2.
go back to reference Gourgiotis S, Vougas V, Germanos S (2007) Operative and non-operative management of blunt hepatic trauma in adults. J Heptobiliary Pancreat Surg 14:387–391CrossRef Gourgiotis S, Vougas V, Germanos S (2007) Operative and non-operative management of blunt hepatic trauma in adults. J Heptobiliary Pancreat Surg 14:387–391CrossRef
3.
go back to reference Gakwaya AM (2004) Blunt liver trauma in Mulago Hospital. East and Cent Afr J Surg 9:85–88 Gakwaya AM (2004) Blunt liver trauma in Mulago Hospital. East and Cent Afr J Surg 9:85–88
4.
go back to reference El-Gamal A, Labib H, Hussein HM, Petkovska J, Daouk Z, Al-Awadi N (2004) Liver injury after blunt abdominal trauma: role of nonoperative management. PAN Arab Med J 25:51–55 El-Gamal A, Labib H, Hussein HM, Petkovska J, Daouk Z, Al-Awadi N (2004) Liver injury after blunt abdominal trauma: role of nonoperative management. PAN Arab Med J 25:51–55
5.
go back to reference Iqbal P, Sial K, Iqbal SA (2000) Liver injuries: management and outcome. Med Channel 6:27–32 Iqbal P, Sial K, Iqbal SA (2000) Liver injuries: management and outcome. Med Channel 6:27–32
6.
go back to reference Ali U, Noor A, Shah M, Alam W, Noor A (2008) Trauma management in a tertiary care hospital in Pneshawar, Pakistan. J Med Res 20:112–115 Ali U, Noor A, Shah M, Alam W, Noor A (2008) Trauma management in a tertiary care hospital in Pneshawar, Pakistan. J Med Res 20:112–115
7.
go back to reference Ahmad N, Abid KJ, Khan AZ, Shah ST (2001) Management of penetrating liver injuries. Ann Surg 07:293–295 Ahmad N, Abid KJ, Khan AZ, Shah ST (2001) Management of penetrating liver injuries. Ann Surg 07:293–295
8.
go back to reference Brammer RD, Bramhall SR, Mirza DF, Mayer AD, McMaster P, Buckels J (2002) 10 years experience of complex liver trauma. Br J Surg 89:1532–1537CrossRefPubMed Brammer RD, Bramhall SR, Mirza DF, Mayer AD, McMaster P, Buckels J (2002) 10 years experience of complex liver trauma. Br J Surg 89:1532–1537CrossRefPubMed
9.
go back to reference Llado L, Jorba R, Pares D, Borobia FG, Biondo S, Farran L, Fabregat J (2002) Influence of the application of a management protocol in the treatment of blunt abdominal trauma [abstract in English]. 72(2):79–83 Llado L, Jorba R, Pares D, Borobia FG, Biondo S, Farran L, Fabregat J (2002) Influence of the application of a management protocol in the treatment of blunt abdominal trauma [abstract in English]. 72(2):79–83
10.
go back to reference Markogiannakis H, Sanidas E, Messaris E, Michalakis I, Kasotakis G, Melissas J, Tsiftsis D (2006) Management of blunt hepatic and splenic trauma in a Greek level I trauma center. Acta Chir Belg 106:566–571CrossRefPubMed Markogiannakis H, Sanidas E, Messaris E, Michalakis I, Kasotakis G, Melissas J, Tsiftsis D (2006) Management of blunt hepatic and splenic trauma in a Greek level I trauma center. Acta Chir Belg 106:566–571CrossRefPubMed
11.
12.
go back to reference Velmahos GC, Toutouzas KG, Radin R, Chan L, Demetriades D (2003) Nonoperative treatment of blunt injury to solid abdominal organs: a prospective study. Arch Surg 138:844–851CrossRefPubMed Velmahos GC, Toutouzas KG, Radin R, Chan L, Demetriades D (2003) Nonoperative treatment of blunt injury to solid abdominal organs: a prospective study. Arch Surg 138:844–851CrossRefPubMed
13.
go back to reference Demirel AH, Basar OT, Ongoren AU, Bayram E, Kisakurek M (2008) Effects of primary fibrin sealant on hemostasis suture and liver regeneration in an experimental liver injury. World J Gastroentrol 14:81–84CrossRef Demirel AH, Basar OT, Ongoren AU, Bayram E, Kisakurek M (2008) Effects of primary fibrin sealant on hemostasis suture and liver regeneration in an experimental liver injury. World J Gastroentrol 14:81–84CrossRef
14.
go back to reference Vatanaprasan T (2005) Operative treatment of hepatic trauma in Vachira Phuket Hospital. J Med Assoc Thai 88:318–328PubMed Vatanaprasan T (2005) Operative treatment of hepatic trauma in Vachira Phuket Hospital. J Med Assoc Thai 88:318–328PubMed
15.
go back to reference Demetriades D, Hadjizacharia P, Constantinou C, Brown C, Inaba K, Rhee P, Salim A (2006) Selective nonoperative management of penetrating abdominal solid organ injuries. Ann Surg 244:620–628PubMedPubMedCentral Demetriades D, Hadjizacharia P, Constantinou C, Brown C, Inaba K, Rhee P, Salim A (2006) Selective nonoperative management of penetrating abdominal solid organ injuries. Ann Surg 244:620–628PubMedPubMedCentral
16.
go back to reference Bismar HA, Alam MK, Al-Keely MH, Al Salamah SM, Mohammed A (2004) Outcome of nonoperative management of blunt liver trauma. Saudi Med J 25:294–329PubMed Bismar HA, Alam MK, Al-Keely MH, Al Salamah SM, Mohammed A (2004) Outcome of nonoperative management of blunt liver trauma. Saudi Med J 25:294–329PubMed
Metadata
Title
Management of Liver Trauma in Minia University Hospital, Egypt
Authors
Abdel Fattah Saleh
Emad Al.Sageer
Amr Elheny
Publication date
01-12-2016
Publisher
Springer India
Published in
Indian Journal of Surgery / Issue 6/2016
Print ISSN: 0972-2068
Electronic ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-015-1393-6

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