Clinical-evolutionary profiles of 45 patients operated for liver trauma

Abstract

Introduction - The management of hepatic trauma has evolved considerably in re-cent years and therapeutic attitudes are becoming more and more conservative. Theobjective of our study was to identify the different diagnostic criteria that establi-shed the operative indication as well as the therapeutic and evolutionary aspects ofpatients operated on for liver injury following a trauma.Results - The average age of operated patients was 30.63 years with extremes from16 to 89. There is a clear male predominance with 89% of cases.Closed trauma to the abdomen (ASD) was found in 64.4% of cases and penetratingwounds in the abdomen in 35.6% of cases. Hemodynamic instability from the outsetwith administration of hemodynamic supports was present in 37.7% of the cases andrequired surgical exploration. Associated extra abdominal lesions were frequent with26.6% of cases of head trauma, 17.7% of cases of hemopneumothorax, one case ofhemo-mediastinum, 11.1% of cases of trauma to the spine and 17.7 % of femur frac-tures.Discussion - The persistence of hemodynamic instability despite the filling measuresconditions the decision to take surgical treatment. Any delay in performing the lapa-rotomy represents a loss of luck and impacts the mortality rate.Conclusion - The prognosis for liver damage during trauma to the abdomen differsdepending on the severity of the injury and its haemorrhagic nature. The existenceof a hemorrhagic shock and the association of intra and / or extra abdominal lesionscondition the prognosis of this type of trauma.

Keywords

• Liver trauma
• Mortality
• Surgical traitment
• Surgery