Liver Trauma (Liver Injury)
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Liver Anatomy (basics), types of liver injuries, ingury scoring scale for liver, CT pictures of different grades, non-operative and operative managment of liver trauma. Download and share Made by Surgical Club Armata Manus (armata-manus.com)
Liver Trauma (Liver Injury)
- 1. Liver Trauma Dr. D. Shamrai, Surgical club Armata manus
- 4. 亠亠仆亳亠 仂仗亠亳仂于舒 仗仂仆亳从舒ﾑ亠亠 舒仆亠仆亳亠 亢亳于仂舒 仗亳 仆舒仍亳亳亳 仗亠亳仂仆亳舒, 亞亠仄仂舒亞亳亠从仂亞仂 仂从舒, 于亳亠舒亳亳 仆亠 亠弍亠 亟舒仍仆亠亶亠亞仂 仗仂亟于亠亢亟亠仆亳 丕, 丐, 仍舒仗舒仂从仂仗亳亳 仆亳 仂亟亳仆 亳亰 亳 仄亠仂亟仂于 仂弍仍亠亟仂于舒仆亳 仆亠 仄仂亢亠 亳亰仄亠仆亳 亠亠仆亳亠 仂弍 仂仗亠舒亳亳.
- 10. 丐亳仗 亰舒从仂亶 舒于仄 仗亠亠仆亳 1) Deceleration (shearing) injuries occur in motor vehicle accidents and in falls from a height where there is movement of the liver in its relatively fixed position; 2) Crush injuries follow direct trauma to the abdomen over the liver area.
- 11. Deceleration (shearing) injuries lacerations between the right posterior section (segments 6 and 7) and the right anterior section (segments 5 and 8), which can extend to involve major vessels; Crush injuries damage to the central portion of the liver (segment 4, 5 and 8) and also may cause bleeding from the caudate lobe (segment 1).
- 15. Grade 1 A stabbing injury to the RUQ of the abdomen Contrast CT demonstrates a small, crescent-shaped subcapsular and parenchymal hematoma less than 1 cm thick.
- 16. Grade 2 A blunt abdominal trauma CT scan at the level of the hepatic veins shows a subcapsular hematoma 3 cm thick.
- 18. Grade 3 A blunt abdominal trauma Contrast CT shows a 4-cm-thick subcapsular hematoma associated with parenchymal hematoma and laceration in segments 6 and 7 of the right lobe of the liver..
- 19. ???
- 20. Grade 4 A blunt abdominal trauma CT scan of the abdomen demonstrates a large subcapsular hematoma measuring more than 10 cm. The high-attenuating areas within the lesion represent clotted blood
- 21. Grade 4 A blunt abdominal trauma Contrast CT shows a large parenchymal hematoma in segments 6 and 7 of the liver with evidence of an active bleed. Note the capsular laceration and large hemoperitoneum.
- 22. Grade 5 A motor vehicle accident CT demonstrates global injury to the liver. Bleeding from the liver was controlled by using Gelfoam.
- 26. 亠仂亟 亳仍亠亟仂于舒仆亳?
- 28. Management Nonoperative management (NOM) for blunt liver trauma (1985, 丐runkey): Haemodynamic stability Absence of peritoneal sign Availability of CT Monitor in ICU Facility of immediate surgery Absence of other organ injuries
- 29. Non-op management (NOM) 亳 NOM 亠弍ﾑ 仂仗亠舒亳于仆仂亞仂 于仄亠舒亠仍于舒 5- 15% 仗舒亳亠仆仂于; 1-3% 仗仂仗亠仆仆 仗仂于亠亢亟亠仆亳亶 从亳亠仆亳从舒; 仍 仗仂亶 舒于仄 亢亳于仂舒 NOM 仂弍亠仄亳仂于舒 仗舒从亳从舒 1987; 仍 仗仂仆亳从舒ﾑ亠亶 舒于仄 亢亳于仂舒 NOM 1994 亞仂亟舒; 仂磦仍亠仆亳亠 亳仍亠亟仂于舒仆亳亶 仗仂 NOM 仂亞仆亠亠仍仆 舒仆亠仆亳亶 仗亠亠仆亳 于 仗仂仍亠亟仆亳亠 亞仂亟; : 束CT scan was mandatory before adopting the NOM損.
- 30. Operative management 仂仗: 亠亟亳仆仆舒 仍舒仗舒仂仂仄亳 亳仍亳 弍亳仍舒亠舒仍仆亶 仗仂亟亠弍亠仆亶 亟仂仗; 亳仆亳仄舒仍仆舒 仄仂弍亳仍亳亰舒亳 仗亠亠仆亳; DCS (Damage control surgery).
- 31. 仂弍亳仍亳亰舒亳 仗亠亠仆亳
- 33. Operative technique/options How? Manual compression Perihepatic packing. Pringle maneuver. Tourniquet Hepatic vascular isolation Placement of atriocaval shunt common Juxtahepatic venous injury
- 34. 亠仄亠仆仆亠 仗仂仂弍 仂舒仆仂于从亳 从仂于仂亠亠仆亳: - 亳亠仄 亳仆亞仍舒; - 丐舒仄仗仂仆亳仂于舒仆亳亠; - 亳仄舒仆舒仍仆舒 从仂仄仗亠亳; - 亳仂从舒于舒仍仆亶 仆.
- 35. 丐舒仄仗仂仆亳仂于舒仆亳亠
- 39. 亳亠仄 Pringle 仂 1 舒舒; 仍亳亠仍仆舒 从仂仄仗亠亳 仂仗舒仆舒; 仍亳 从仂于仂亠亠仆亳亠 亳亰 仗舒亠仆亳仄 仗亠亠仆亳 仆亠 仂舒仆仂于仍亠仆仂, 亰仆舒亳 亳仄亠亠 仄亠仂 仗仂于亠亢亟亠仆亳亠 亠仂仗亠亠仆仂仆仂亞仂 仂亟亠仍舒 .
- 42. 仂弍亳仍亳亰舒亳 仗亠亠仆亳
- 43. 从仂仆舒亠仍仆舒 仂舒仆仂于从舒 从仂于仂亠亠仆亳: - 从舒亠亠 个仂仍亠亶; - 弍舒仍仍仂仆 仂亞亠亳 (Poggetti); - 亠亰亠从亳亳 仗亠亠仆亳 (亠从亳仂从仂仄亳亳, 舒亳仗亳仆亠 亠亰亠从亳亳 仗亠亠仆亳, 亞亠仄亳亞亠仗舒从仂仄亳亳)
- 44. by Poggetti
- 45. Foley Catheter
- 47. 丼亠亠亰 9 仄亠亠于 仗仂仍亠 仗舒于仂仂仂仆仆亠亶 亞亠仄亳亞亠仗舒从仂仄亳亳
- 52. Thank you for attention Support lecturer by the like armata-manus.com vk.com/armata_manus facebook.com/armatamanus Dr. D. Shamrai, shamraydv@gmail.com, facebook.com/dmitriy.shamrai