A 17-year-old boy is admitted to the hospital after a road traffic accident. Per abdomen examination is normal. After adequate resuscitation, his pulse rate is 80/min and BP is 110/70 mm Hg. Abdominal CT reveals 1 cm deep laceration in the left lobe of the liver extending from the dome more than half way through the parenchyma. Appropriate management at this time would be:
Stable + Left lobe Laceration= no organ bleeding- Conservative Treatment of HEPATIC INJURY - Mechanism of blunt hepatic trauma: Compression with direct parenchymal damage and shearing forces, which tear hepatic tissue and disrupt vascular and ligamentous attachments - Most liver injuries (>85%) involves segments 6,7 and 8 of the liver. - Most liver injury bleeding is venous; and therefore low pressure, tamponade is readily performed Protocol for Liver Trauma:
Conservative treatment
Abdominal exploration and packing of hepatic wounds
Abdominal exploration and ligation of left hepatic aery
Left hepatectomy
Trauma