Mitre Kalil1, Isaac Massaud Amim Amaral2. 1. Departamento de Clínica Cirúrgica, Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória, Brasil. 2. Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória, Brasil.
Abstract
OBJECTIVE: to evaluate the epidemiological variables and diagnostic and therapeutic modalities related to hepatic trauma patients undergoing laparotomy in a public referral hospital in the metropolitan region of Vitória-ES. METHODS: we conducted a retrospective study, reviewing charts of trauma patients with liver injuries, whether isolated or in association with other organs, who underwent exploratory laparotomy, from January 2011 to December 2013. RESULTS: We studied 392 patients, 107 of these with liver injury. The male: female ratio was 6.6 : 1 and the mean age was 30.12 years. Penetrating liver trauma occurred in 78.5% of patients, mostly with firearms. Associated injuries occurred in 86% of cases and intra-abdominal injuries were more common in penetrating trauma (p <0.01). The most commonly used operative technique was hepatorrhaphy and damage control surgery was applied in 6.5% of patients. The average amounts of blood products used were 6.07 units of packed red blood cells and 3.01 units of fresh frozen plasma. The incidence of postoperative complications was 29.9%, the most frequent being infectious, including pneumonia, peritonitis and intra-abdominal abscess. The survival rate of patients suffering from blunt trauma was 60%, and penetrating trauma, 87.5% (p <0.05). CONCLUSION: despite technological advances in diagnosis and treatment, mortality rates in liver trauma remain high, especially in patients suffering from blunt trauma in relation to penetrating one.
OBJECTIVE: to evaluate the epidemiological variables and diagnostic and therapeutic modalities related to hepatic traumapatients undergoing laparotomy in a public referral hospital in the metropolitan region of Vitória-ES. METHODS: we conducted a retrospective study, reviewing charts of traumapatients with liver injuries, whether isolated or in association with other organs, who underwent exploratory laparotomy, from January 2011 to December 2013. RESULTS: We studied 392 patients, 107 of these with liver injury. The male: female ratio was 6.6 : 1 and the mean age was 30.12 years. Penetrating liver trauma occurred in 78.5% of patients, mostly with firearms. Associated injuries occurred in 86% of cases and intra-abdominal injuries were more common in penetrating trauma (p <0.01). The most commonly used operative technique was hepatorrhaphy and damage control surgery was applied in 6.5% of patients. The average amounts of blood products used were 6.07 units of packed red blood cells and 3.01 units of fresh frozen plasma. The incidence of postoperative complications was 29.9%, the most frequent being infectious, including pneumonia, peritonitis and intra-abdominal abscess. The survival rate of patients suffering from blunt trauma was 60%, and penetrating trauma, 87.5% (p <0.05). CONCLUSION: despite technological advances in diagnosis and treatment, mortality rates in liver trauma remain high, especially in patients suffering from blunt trauma in relation to penetrating one.
Authors: Carlos A Ordoñez; Michael W Parra; Mauricio Millán; Yaset Caicedo; Mónica Guzmán-Rodríguez; Natalia Padilla; Juan Carlos Salamea-Molina; Alberto García; Adolfo González-Hadad; Luis Fernando Pino; Mario Alain Herrera; Fernando Rodríguez-Holguín; José Julián Serna; Alexander Salcedo; Gonzalo Aristizábal; Claudia Orlas; Ricardo Ferrada; Thomas Scalea; Rao Ivatury Journal: Colomb Med (Cali) Date: 2020-12-30
Authors: Aleksey K Vorontsov; Vladislav P Troshin; Yuri A Parkhisenko; Anton V Korsakov; Aleksandr V Klimashevich Journal: Acta Clin Croat Date: 2022-02 Impact factor: 0.780