[Conservative treatment of hepatic injuries. Management and course].
From January 1986 to June 1994, 252 cases of closed liver trauma were treated in an emergency setting. Non surgical conservative management, after a complete imaging work-up including CT scan in all cases, was applied in 142 cases (56.3%) with no hemodynamic complication. The spontaneous outcome in these cases was quite favourable in 131 (92.2%); all lesions had disappeared in 4 to 36 weeks. Complications were observed in only 6 cases: 2 intrahepatic abscesses managed with percutaneous drainage were not further complicated, 1 biliari fistula required surgical exploration, 1 intrahepatic bilioma was drained percutaneously, 1 disinsertion of the gallbladder was treated by laparoscopy and 1 operation for bleeding was required 48 hours after the trauma in 1 case. No deaths could be directly imputed to the liver trauma, 5 patients died from neurological causes. Non-surgical conservative treatment combined with strict prolonged surveillance is a reliable management option for patients with closed liver trauma.
Carles
J
J
Service de Chirurgie Viscérale, Hôpital Pellegrin-Tripode, Bordeaux.
Dubuisson
V
V
Douws
C
C
Chahine
Z
Z
Grenier
N
N
Videau
J
J
D000293:Adolescent; D000328:Adult; D002648:Child; D003288:Contusions / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D004630:Emergencies; D005260:Female; D006801:Humans; D008099:Liver / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014057:Tomography, X-Ray Computed
Traitement conservateur des traumatismes hépatiques. Prise en charge et évolution.