title: [Conservative management of liver trauma and its complications: current gold-standard].
abstract: BACKGROUND
  The liver is the second most frequently involved organ in abdominal trauma in children. The aim of this study was to review the characteristics of liver traumas (LT) in children, its treatment and complications.
  
  
  METHODS
  Retrospective study of patients with LT treated between 2010-2014. We analyzed data regarding diagnosis, conservative management (CM), complications and treatment.
  
  
  RESULTS
  Twenty-four patients of LT with a mean age of 9.8 years (SD: 3.4) were treated at our center. Liver injury degrees according to the Organ Injury Scale of American Association for Surgery of Trauma (AAST) were: grade I (4), grade II (6), grade III (8), grade IV (5) and grade V (1). CT angiography was performed in 23 patients. Four of the six patients with initial hemodynamic instability required blood transfusion; of those, two required angioembolization for active bleeding in extrahepatic locations and a third required damage control surgery. Three patients presented late-onset complications: 2 large size bilomas which underwent spontaneous resolution and a third patient with a right biloma and section of the left bile duct who required a multidisciplinary approach. Median hospital stay was 6 days (r 1-92). With a mean follow-up of 17.75 months (SD: 16.35) (r: 2-57) long-term survival was 96%. The patient who received surgery died due to a post-traumatic brain injury.
  
  
  CONCLUSIONS
  CM seems to be the treatment of choice in LT regardless of injury degree. Surgery should be reserved for cases refractory to CM due to the associated high mortality.
authors.affiliation: Servicio de Cirugía Pediátrica. Programa de Trauma Pediátrico. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: R
authors.initials: R
authors.lastname: Gander
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: J A
authors.initials: JA
authors.lastname: Molino
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: S
authors.initials: S
authors.lastname: Santiago
authors.affiliation: Servicio de Cirugía Pediátrica. Programa de Trauma Pediátrico. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: A
authors.initials: A
authors.lastname: Laín
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: G
authors.initials: G
authors.lastname: Guillén
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: C
authors.initials: C
authors.lastname: Giné
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: G
authors.initials: G
authors.lastname: Royo
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: S
authors.initials: S
authors.lastname: López
authors.affiliation: Servicio de Radiología Vascular Intervencionista. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: M
authors.initials: M
authors.lastname: Pérez
authors.affiliation: Servicio de Radiología Vascular Intervencionista. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: I
authors.initials: I
authors.lastname: Díez
authors.affiliation: Programa de Trauma Pediátrico. Unidad de Urgencias Pediátricas. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: S
authors.initials: S
authors.lastname: Cañadas
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: J
authors.initials: J
authors.lastname: Lloret
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: J
authors.initials: J
authors.lastname: Bueno
mesh_terms: D002648:Child; D000072700:Conservative Treatment; D006470:Hemorrhage / Q000628:therapy; D006801:Humans; D015601:Injury Severity Score; D008099:Liver / Q000293:injuries*; D011183:Postoperative Complications; D012015:Reference Standards; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000145:classification / Q000628:therapy
keywords: Abdominal injury; Hepatic blunt trauma; Interventional radiology; Paediatric; Trauma