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Bulletin of Emergency and Trauma، جلد ۷، شماره Issue ۱، صفحات ۴۹-۵۴
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عنوان انگلیسی Non-Operative Management of Blunt Liver Trauma: Safety, Efficacy and Complications of a Standardized Treatment Protocol
چکیده انگلیسی مقاله Objective: To evaluate the safety and effectiveness of NOM (nonoperative management) in the treatment of blunt liver trauma, following a standardized treatment protocol.Methods: All the hemodynamically stable patients with computed tomography (CT) diagnosis of blunt liver trauma underwent NOM. It included strict clinical and laboratory observation, 48-72h contrast enhanced ultrasonography (CEUS) or CT follow-up, a primary angioembolization in case of admission CT evidence of vascular injuries and a secondary angioembolization in presence of vascular injuries signs at follow-up CEUS.Results: 181 patients (85.4%) [55 (30.4%) women and 126 (69.6%) men, median age 39 (range 14–71)] were included. Of these, 63 patients (34.8%) had grade I, 48 patients (26.5%) grade II, 39 patients (21.5%) grade III, 21 patients (11.6%) grade IV and 10 patients (5.5%) grade V liver injuries. The overall success rate of NOM was 96.7% (175/181). There was not significant difference in the success rate between the patients with different liver injuries grade. Morbidity rate was 7.4% (13/175). Major complications (2 bilomas, 1 liver hematoma and 2 liver abscesses) were successfully treated by CEUS or CT guided drainage. Eighteen (18/181) patients (9.9%) underwent angioembolization with successful results.Conclusion: Nonoperative management of blunt liver trauma represents a safe and effective treatment for both minor and severe injuries, achieving an high success rate and an acceptable morbidity rate. The angiographic study with embolization, although required only in selected cases of vascular injuries, represents a fundamental therapeutic option in a significant percentage of patients.
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نویسندگان مقاله Antonio Brillantino |
Department of Surgery “A. Cardarelli” Hospital

Francesca Iacobellis |
Department of Radiology, “A. Cardarelli” Hospital

Patrizio Festa |
Department of Surgery “A. Cardarelli” Hospital

Arianna Mottola |
Department of Surgery “A. Cardarelli” Hospital

Ciro Acampora |
Department of Radiology “A. Cardarelli” Hospital

Fabio Corvino |
Interventional Radiology Department, “A Cardarelli” Hospital

Santolo Del Giudice |
Department of Surgery “A. Cardarelli” Hospital

Michele Lanza |
Department of Surgery “A. Cardarelli” Hospital

Mariano Armellino |
Department of Surgery “A. Cardarelli” Hospital

Raffaella Niola |
Interventional Radiology Department, “A Cardarelli” Hospital

Luigia Romano |
Department of Radiology “A. Cardarelli” Hospital

Maurizio Castriconi |
Department of Surgery “A. Cardarelli” Hospital

Maurizio De Palma |


Giuseppe Noschese |
Department of Surgery “A. Cardarelli” Hospital

نشانی اینترنتی http://beat.sums.ac.ir/article_44473_cfdf3f19a9056536d7649615db3229d7.pdf
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