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吻合器辅助肝段切除术治疗伴腹膜炎的Ⅴ级肝损伤:1例报告

Grade V Liver Injury Presented With Peritonitis Treated With Stapler-Assisted Hepatic Segmentectomy: A Case Report.

作者信息

Mena Albors Laura, Reiss Samantha, Shen Adam, Ang Darwin

机构信息

General Surgery, University of Central Florida College of Medicine, Orlando, USA.

Medical School, University of Central Florida College of Medicine, Orlando, USA.

出版信息

Cureus. 2023 Jul 6;15(7):e41436. doi: 10.7759/cureus.41436. eCollection 2023 Jul.

Abstract

The liver is one of the most commonly injured solid organs in blunt abdominal trauma. In patients who are hemodynamically normal, most cases of blunt liver injuries are managed conservatively. At present, nonoperative management (NOM) is the standard of care for both minor and severe liver injuries. Usually, patients with severe liver injuries, i.e., grades IV and V, are treated with surgical intervention versus angioembolization depending if patients are hemodynamically stable or not. We present a hemodynamically stable 53-year-old male patient with a grade V blunt liver injury with complete avulsion of the left lobe of the liver after a motor vehicle collision (MVC). Very few cases of complete hepatic avulsions have been published in the literature. We discuss surgical management with stapler-assisted hepatectomy in emergency trauma laparotomy for bleeding control.

摘要

肝脏是钝性腹部创伤中最常受损的实体器官之一。在血流动力学正常的患者中,大多数钝性肝损伤病例采用保守治疗。目前,非手术治疗(NOM)是轻度和重度肝损伤的标准治疗方法。通常,对于重度肝损伤患者,即IV级和V级患者,根据患者血流动力学是否稳定,采用手术干预或血管栓塞治疗。我们报告一例53岁血流动力学稳定的男性患者,在机动车碰撞(MVC)后发生V级钝性肝损伤,左肝叶完全撕脱。文献中很少有完全性肝撕脱的病例报道。我们讨论了在急诊创伤剖腹手术中使用吻合器辅助肝切除术进行出血控制的手术治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec16/10404113/b65e7ff408d6/cureus-0015-00000041436-i01.jpg

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