Diagnosis and Treatment of Liver Injuries

Overview

Aim:
The aim is to specify contemporary diagnostic and therapeutic procedures of liver injuries.

Methodology:
The authors present a trial group of 117 patients with various stages of liver injuries hospitalized at the Traumacentrum Surgical Department of the Faculty Hospital in Plzeň from 1. 1. 2000 to 31. 9. 2005. 61 injured (52.1%) were treated conservatively, 56 (47.9%) surgically, who underwent 87 procedures, in total.

Results:
10 polytrauma patients exited (8.5%) from a haemorrhagic shock (group Moore IV-VI). Six subjects (5.1%) had complications on hospitalization. Average hospitalization lasted 18 days (1–69 days).

Conclusion:
The basic diagnostic tools in liver injuries include „bed side“ ultrasonography, spiral computer tomography, in more complicated traumas also MRI, angiography or endoscopic retrograde cholangiography. As a treatment strategy, conservative methods prevail in haemodynamically stable patients, regardless of the liver injury stage. The objective of the surgical management is to provide „damage control surgery“, i.e. the first procedure is aimed at life-saving, no time-demanding surgical procedures (e.g. liver tamponade), management of hypothermia, haemocoagulation and metabolic acidosis.

Key words:
liver injury – diagnosis – treatment strategy