Grade IV blunt hepatic injury treated conservatively and successfully in a non-trauma centre: a case report

Authors

  • Sebastian Berg Department of Surgery. Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
  • Jean-Charles de Schoutheete Department of Surgery. Queen Astrid Military Hospital, Bruynstraat 1, 1120 Brussels, Belgium
  • Davide Di Mauro Department of Upper Gastro-Intestinal Surgery. Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon, EX2 5DW, United Kingdom
  • Matteo Gregori Department of Upper Gastro-Intestinal Surgery. Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon, EX2 5DW, United Kingdom
  • Edoardo Ricciardi Department of Upper Gastro-Intestinal Surgery. Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon, EX2 5DW, United Kingdom
  • Antonio Manzelli Department of Upper Gastro-Intestinal Surgery. Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon, EX2 5DW, United Kingdom

DOI:

https://doi.org/10.18203/2349-2902.isj20212726

Keywords:

Trauma, Blunt hepatic injury, Nonoperative management, Interventional radiology, Endoscopy

Abstract

Management of blunt hepatic injury changed over the past three decades as a non-operative treatment is nowadays advocated by most in haemodynamically stable patients. We present the case of a young female patient with a high-grade blunt liver injury successfully treated in a non-trauma centre. She developed several complications secondary to the injury like a delayed bleeding, two different bilomas and a reactive pleural effusion requiring surgical expertise, interventional radiology, upper gastro-intestinal endoscopy and intensive care facilities. In the literature, the mortality and the morbidity rates for grade IV liver injuries respectively reach 16% and 39%. Because of potential delayed symptoms or signs and high complication rate, we think it should be appropriate to manage such a complex patient in a centre where at least above-mentioned specialities are available. Otherwise, a referral to a trauma centre should be a better option.

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Published

2021-06-28

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Case Reports