Cirocchi R, Contine A, Mazieri M, Bisacci R, Fabbri C, Bisacci C, Fabbri B
Dipartimento di Chirurgia ed Emergenze Chirurgiche, Università degli Studi, Perugia.
Chir Ital. 1999 May-Jun;51(3):259-64.
After the spleen the liver is the most exposed organ to injury in abdominal blunt trauma. The improvement in imaging techniques and in anesthesia and intensive care have contributed to a fallen in mortality rate and an enhanced possibility in non-operative management. In unstable patients the packing may be used to defer the definitive operation. The Authors report a case of liver injury of two lobes where the packing was followed by liver wrapping with an absorbable mesh. The patient, a female aged 67, resulted to have a bilobar liver injury of IV degree in the injury severity score. The delay of reoperation was 15 days. The procedure was complicated by a subphrenic abscess, successfully managed with non-operative procedures. Wrapping after liver packing may be considered a good option in unstable patient affected, by severe liver injuries after blunt abdominal traumas.
在腹部钝性创伤中，肝脏是仅次于脾脏的最易受损伤的器官。成像技术、麻醉和重症监护的改进有助于降低死亡率，并增加非手术治疗的可能性。对于不稳定的患者，可采用填塞法推迟确定性手术。作者报告了一例两叶肝脏损伤的病例，在填塞后用可吸收网片进行肝脏包裹。该患者为67岁女性，损伤严重程度评分为IV度双叶肝损伤。再次手术延迟了15天。该手术并发膈下脓肿，通过非手术方法成功处理。对于腹部钝性创伤后严重肝损伤的不稳定患者，肝脏填塞后进行包裹可能是一个不错的选择。
