TY - JOUR ID - 44473 TI - Non-Operative Management of Blunt Liver Trauma: Safety, Efficacy and Complications of a Standardized Treatment Protocol JO - Bulletin of Emergency And Trauma JA - BEAT LA - en SN - 2322-2522 AU - Brillantino, Antonio AU - Iacobellis, Francesca AU - Festa, Patrizio AU - Mottola, Arianna AU - Acampora, Ciro AU - Corvino, Fabio AU - Del Giudice, Santolo AU - Lanza, Michele AU - Armellino, Mariano AU - Niola, Raffaella AU - Romano, Luigia AU - Castriconi, Maurizio AU - De Palma, Maurizio AU - Noschese, Giuseppe AD - Department of Surgery “A. Cardarelli” Hospital AD - Department of Radiology, “A. Cardarelli” Hospital AD - Department of Radiology “A. Cardarelli” Hospital AD - Interventional Radiology Department, “A Cardarelli” Hospital AD - Y1 - 2019 PY - 2019 VL - 7 IS - Issue 1 SP - 49 EP - 54 KW - Hepatic trauma KW - Liver injury KW - Blunt trauma KW - Nonoperative management KW - Angioembolization DO - 10.29252/beat-070107 N2 - Objective: To evaluate the safety and effectiveness of NOM (nonoperative management) in the treatment of blunt liver trauma, following a standardized treatment protocol.Methods: All the hemodynamically stable patients with computed tomography (CT) diagnosis of blunt liver trauma underwent NOM. It included strict clinical and laboratory observation, 48-72h contrast enhanced ultrasonography (CEUS) or CT follow-up, a primary angioembolization in case of admission CT evidence of vascular injuries and a secondary angioembolization in presence of vascular injuries signs at follow-up CEUS.Results: 181 patients (85.4%) [55 (30.4%) women and 126 (69.6%) men, median age 39 (range 14–71)] were included. Of these, 63 patients (34.8%) had grade I, 48 patients (26.5%) grade II, 39 patients (21.5%) grade III, 21 patients (11.6%) grade IV and 10 patients (5.5%) grade V liver injuries. The overall success rate of NOM was 96.7% (175/181). There was not significant difference in the success rate between the patients with different liver injuries grade. Morbidity rate was 7.4% (13/175). Major complications (2 bilomas, 1 liver hematoma and 2 liver abscesses) were successfully treated by CEUS or CT guided drainage. Eighteen (18/181) patients (9.9%) underwent angioembolization with successful results.Conclusion: Nonoperative management of blunt liver trauma represents a safe and effective treatment for both minor and severe injuries, achieving an high success rate and an acceptable morbidity rate. The angiographic study with embolization, although required only in selected cases of vascular injuries, represents a fundamental therapeutic option in a significant percentage of patients. UR - https://beat.sums.ac.ir/article_44473.html L1 - https://beat.sums.ac.ir/article_44473_cfdf3f19a9056536d7649615db3229d7.pdf ER -