Biomechanic study of the human liver during a frontal deceleration.
BACKGROUND
Mechanisms of hepatic injury remain poorly understood. Surgical literature reports some speculative theories that have never been proved. The aim of this study was to examine the behavior of the liver during brutal frontal deceleration.


METHODS
Six trunks, removed from human cadavers, underwent free falls at 4, 6, and 8 meters per second (mps). Accelerometers were positioned in the two lobes of the liver, in front of the vertebra L2, and in the retro hepatic inferior vena cava. Relative motions of the lobes of the liver and of the two other anatomic marks were observed. In parallel, numerical simulations of this experiment have been performed using a finite element model.


RESULTS
In the direction of impact, the vertebra L2 had no considerable displacement with the inferior vena cava. There was a noteworthy displacement between the two hepatic lobes. The left hepatic lobe had a large relative displacement with the vertebra L2 and the inferior vena cava. The right hepatic lobe was more stable with the vertebra L2 and the inferior vena cava. Numerical simulation of the same protocol underlined a rotation effect of the liver to the left around the axis of the inferior vena cava.


CONCLUSIONS
These results support the surgical data. They highlight a crucial zone and explain how dramatic lacerations between the two lobes of the liver can occur.
Cheynel
Nicolas
N
Laboratory of Applied Biomechanics, UMRT24/INRETS/University of Méditerranée, Marseille, France.
Serre
Thierry
T
Arnoux
Pierre-Jean
PJ
Baque
Patrick
P
Benoit
Laurent
L
Berdah
Stephane-Victor
SV
Brunet
Christian
C
D000368:Aged; D001696:Biomechanical Phenomena; D003654:Deceleration / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008099:Liver / Q000293:injuries*; D008297:Male; D008954:Models, Biological