Background: Hepatic trauma is the second injury of closed abdominal injury, but it is the leading cause of death. The most of hepatic trauma due to closed abdominal injury caused by traffic accident. Objectives: To assess determinants to treatment attitude of hepatic trauma patients treated in Viet Duc hospital. Subjects and method: A cross-section descriptive study was conducted on 157 patients with closed abdominal injury (118 male, 39 female), was diagnosed with hepatic trauma, treated in Viet Duc hospital from January, 2004 to April, 2006. Results: The average age of patients were 28.9\xb113 for male, 28.8\xb112 for female. The common occupations were farmers (35.7%), workers (14.6%), no professional 14.6% and other jobs (35.1%). Combined injuries included: cranial trauma (9.6%), facial trauma (10.2%), chest trauma (17.2%), major bone trauma (7.6%). 19.7% patients with combined injuries were operated. 130 patients with hepatic trauma (82.2%) was detected by ultrasound, 1 patient with splenic trauma combined hepatic repture. The differences between shock of admission, level of hepatic trauma and the amount of blood in abdominal CT scans to treatment attitude were having a statistically significant with p<0.001, p<0.001 and p=0.005, respective. Conclusion: Recently, the treatment attitudes with hepatic trauma patients have more changed. Hemodynamic stability, clinical close monitoring, excluding combined injuries required surgery and assessing injuries by CT scans are important factors to indicate conservation therapy for hepatic trauma. Conservation therapy is safe and effective in the treatment of hepatic trauma in Viet Duc hospital.
Liver/ injuries ; Attitude ;

Background: The liver is the largest organ in the abdomen, which is very vulnerable in closed abdominal injury. Clinical features of the mild injuries (grade I, II) are unclear, so they should be closely monitored for treating timely. The severe injuries (level IV, V) are often accompanied by other injuries such as rupture of the kidney, pancreas injury,.... required timely surgical treatment with intensive care. Objectives: to evaluate results of operative treatment in patients with hepatic injury surgery transferred to Viet Duc Hospital from other hopitals. Subjectives and Method: a retrospective descriptive study, the all of medical records of patients with liver trauma who have postoperative complications transferred to Viet Duc Hospital from January 1 2004 to June 30, 2006. Results: 16 patients, 12 men (75%), 3 women (25%), 15 patients had complete data, including 13 patients (87.75%) with symptoms of shock. 2 patients with mild pain (12.50%) who have liver rupture with grade I, II on CT, after operated to show: only whipping with catgut and lin. 2 patients with diaphragm rupture, a large bulge-diaphragm rupture, in which a patient was operated 2 times because incision was too small to exploring the injuries. 2 patients were pressed gauze because complex liver rupture, accompanied with pancreas rupture and kidney rupture, so the transfer of these patients was true. Conclusions: among the patients, most patients had no summary of medical record. Besides timely treatment, correctly and appropriately treatment plays an important role.
Liver/ injuries ; surgery ;

Background: Nonoperative management (NOM) is presently considered the treatment modality of choice for hemodynamically stable patients sustaining blunt liver trauma, especially in children. Objective: To evaluate role of NOM of blunt liver injuries (BLI) in children at National Hospital of Pediatrics. Subjects and method: Therecords ofallthe patientstreatedin National HospitalofPediatricswithfinaldiagnosisBLI betweenJanuary2000 and December 2006 were reviewed. The clinical signs,investigations,imagingstudies, methods oftreatmentandresultswereanalysed.Theliverinjuriesweregradedaccordingtothe American AsociationfortheSurgeryofTrauma(AAST).Results: There were15patients from one dayto 12 years of age with average BLI grade 2.5; 14 patients with precise diagnosis BLI were atempted NOM, 1 neonate was operated with diagnosis intraabdominal haemorrhage (BLI grade II found intraoperatively). Two patients (BLI grade II and V) from the atempted NOM group were operated thereafter because of hemodynamical instability or continuing bleeding, the remained 12recovered well with average hospital stay of 7.5 days. The rate of succesful NOM for BLI in our series was 12/14 (85.7%). Conclusions: NOM can be applied safely for BLI in children with high successful rate. Patients\ufffd?hemodynamic status may be more important for treatment decision-making than the injury grade according to the AAST based on ultrasound or CT.
Liver/ injuries ; Child ; Role ;

Humans ; Liver ; injuries ; surgery

A retrospective study was conducted concerning the analysis of data. Trauma were classified according to Moore'standard and the locations of the wound were identified according to T«n ThÊt Tïng. To diagnose, ultrason was used commonly. Most of cases were treated surgically and the technique were described in details. Mortality was 13.13% and the complications comprised of hemorrhagia, under diaphragm abscess, bile perforation, pleuresia, infection of the wound and renal failure
Liver ; Wounds and Injuries ; diagnosis ; therapeutics

Breaking in the site of connection of esophage and cardia is a rare condition in the close abdomen trauma with a high mortality. Its cause is usually a sudden rise of pressure in the abdomen cavity or an error in operation. Early diagnosis is most importance. Tomography is helpful to diagnose the emphysema in the chest in abdomen surgery is an approach od choise
Wounds and Injuries ; Liver ; Abdomen ; Cardia

Background: Hepatic trauma is a common disease in surgical emergency. Nowadays, there are many means of diagnostic imaging such as ultrasound, computerized tomography, magnetic resonance imaging.. but computerized tomography is more valuable in the diagnosis and treatment decisions. Objectives: To assess the value of computerized tomography in diagnosis of hepatic trauma. Subjects and method: To conduct computerized tomography on 36 patients with hepatic trauma (28 male, 8 female, aged 5-70 year olds), was diagnosed by ultrasound in Viet Duc hospital from January, 2005-June, 2005. Results: Major cause of the trauma was still due to traffic accidents (77.8%), followed by living and occupational accidents (61.5%). Using computerized tomography, there were only 12 patients undergoing surgery, the remainders were conservative treated. The common signs were: fluids in abdominal cavity: 33/36 patients (91.7%), without fluids in abdominal cavity: 3 patients. Parenchyma crush: 28/36 patients (77.8%). The most common lesion site was right liver. Diagnostic CT scans at 4 or more degrees was necessary during considering surgical indication for cases of having combined injuries, which can lead to hemodynamic dysfunction. Therefore, clinicians tend to use conservative therapy in hepatic trauma. Conclusion: CT scans was chosen as major examination to determine exactly level of lesions and to decide procedures.
Liver/ injuries ; Tomography ; X-Ray Computed ;

Laparotomy or thoracolaparotomy is a traditional management approach for thoracoabdominal impalement injury associated with major liver and diaphragmatic injuries. We successfully treated the impalement injury with minimally invasive management. A male was brought to our trauma centre with the 15 cm long handle of the knife protruded from right lateral thoracoabdominal region. CT scan revealed that the knife blade traversed through the right costophrenic recess into segment 8 of the liver. There was an intraparenchymal haematoma and a collection of fluid in the abdominal cavity. The conservative management plan consisting of removing the impaled knife, observing, monitoring and managing complications was undertaken. A multidisciplinary approach to manage a patient with less invasive techniques yielded a good outcome. This management option may be considered as an alternative for open surgery for hemodynamically stable patients in experienced centres.
Abdominal Injuries ; therapy ; Adolescent ; Diaphragm ; injuries ; Humans ; Liver ; injuries ; Male ; Minimally Invasive Surgical Procedures ; Thoracic Injuries ; therapy ; Wounds, Penetrating ; therapy

BACKGROUNDThe aim of this research was to evaluate the feasibility and efficacy of absorbable bandage wrapping in the treatment of cases of severe liver trauma.

METHODSElectric firecrackers were detonated in 16 miniature swine to produce a severe blast liver injury. After fluid resuscitation, the animals were randomly divided into two groups (n = 8 each) and were either treated with absorbable bandage wrapping of the injured lobe of liver (Group B) or hepatic lobectomy (Group H). Time to hemostasis, blood loss during the treatment period, and other parameters were compared, including postoperative serum total bilirubin (TB), alanine aminotransferase (ALT), and aspartate aminotransferase (AST).

RESULTSBlood loss during the treatment period was significantly lower in Group B than that in Group H ((81.3 ± 26.0) ml vs. (130.8 ± 29.5) ml, P = 0.0031). Serum AST and ALT were transiently increased post-surgically. These transient increases were significantly higher in Group B. No difference in time to hemostasis was noted ((8.70 ± 2.27) minutes vs. (10.28 ± 1.93) minutes, P = 0.1559) in Groups B and H, respectively. Two pigs were humanely euthanized 28 days post-surgically and the wrapped liver lobes appeared atrophies. Microscopically, there was evidence of emerging and mature fibrous tissue.

CONCLUSIONAbsorbable bandage wrapping is both feasible and effective in the treatment of severe blast liver injury.

Diquat is a kind of conductive contact-killing herbicides. The damage of central nervous system is relatively common, but the peripheral neuropathy caused by diquat has not been reported yet. In September 2021, we treated a patient with diquat poisoning. During the hospitalization, the patient was diagnosed with peripheral neuropathy. Therapy for peripheral nerve injury was given on the basis of conventional treatment of poisoning. The patient was discharged after his condition was stable. The follow-up showed that the peripheral neuropathy of patient was better than before. According to the condition of this patient, it is suggested that we should not only protect the function of gastrointestinal tract, liver, kidney, and central nervous system early, but should also pay attention to the damage of peripheral nervous system in clinical work. We should intervene earlier to improve the prognosis of patients.
Humans ; Diquat ; Herbicides ; Kidney ; Liver ; Peripheral Nerve Injuries ; Poisoning