Severe liver injury

4/19/01


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Table of Contents

Severe liver injury

What is a severe liver injury?

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Initial presentation

Severity of liver trauma

Severity of liver trauma

Initial decision process

Management of stable injuries

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The unstable patient

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Liver anaesthesia

Three stages of trauma laparotomy

Indications for damage control

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Initial approach in the OR

Adequate exposure

Packing

Considerations for obtaining vascular control

Other approaches where packing is insufficient for haemostasis

Mesh wrapping

Resectional debridement

Mass ligation

Formal lobectomy

Formal lobectomy

Other considerations in deciding how to approach major liver injury

The role of angiography

Angiography

Angiography

Angiography

Angiography

Angiography

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Summary

Author: Ian Civil

Email: philb@ahsl.co.nz