Liver transplantation has been reported in the literature as an extreme intervention in cases of severe and complicated hepatic trauma.The main indications for liver transplant in such cases were uncontrollable bleedi...Liver transplantation has been reported in the literature as an extreme intervention in cases of severe and complicated hepatic trauma.The main indications for liver transplant in such cases were uncontrollable bleeding and postoperative hepatic insufficiency.We here describe four cases of orthotopic liver transplantation after penetrating or blunt liver trauma.The indications were liver failure,extended liver necrosis,liver gangrene and multiple episodes of gastrointestinal bleeding related to portal hypertension,respectively.One patient died due to postoperative cerebral edema.The other three patients recovered well and remain on immunosuppression.Liver transplantation should be considered as a saving procedure in severe hepatic trauma,when all other treatment modalities fail.展开更多
Liver is one of the organs with the highest injury rate, and in recent decades, the guidelines for the treatment of liver trauma have changed considerably. Now, there is a growing consensus that the most important ste...Liver is one of the organs with the highest injury rate, and in recent decades, the guidelines for the treatment of liver trauma have changed considerably. Now, there is a growing consensus that the most important step is diagnosis and depending upon the degree of severity, non-operative therapy is the main treatment method for hepatic trauma if conditions permit. For serious hepatic trauma patients such as those with hemodynamic instability, they should be operated upon as soon as possible. Regardless of the surgical options, doctors should control damage to patients and try to prevent complications. New therapies such as hepatic artery embolization and liver transplantation have been more and more used for the treatment of serious heoatic damage in clinics.展开更多
To probe into effective surgical procedures and improve the outcome of treatment for patients with severe hepatic injury. Methods: A retrospective study involving 113 patients with seve re hepatic trauma (AAST grade I...To probe into effective surgical procedures and improve the outcome of treatment for patients with severe hepatic injury. Methods: A retrospective study involving 113 patients with seve re hepatic trauma (AAST grade IV and V) during the past 12 years was carried out . Ninety eight patients underwent surgical treatment. Surgical interventions in cluding hepatectomy or direct control of bleeding vessels by finger fracture tec hnique with Pringle maneuver, selective ligation of hepatic artery, retrohepatic caval repair with total hepatic vascular occlusion, and perihepatic packing wer e mainly used. Results: In the 98 patients treated operatively, the survival r ate was 69.4 % (68/98). Among 40 patients with juxtahepatic venous injury (JH VI), 15 were cured with the maximum blood transfusion of 12 000 ml. Eight ca ses of Grade IV injury treated nonoperatively were cured. The percentage of fail ure of nonoperative management was 42.9 % (6/14). The overall mortality rate was 32.7 % (37/113), and 57% of the deaths were due to exsanguination. Conclusions: Reasonable surgical procedures based on classifica tion of hepatic injuries can increase the survival rate of severe liver trauma. Accurate perihepatic packing is effective in dealing with JHVI.展开更多
Background:White smoke bomb exposure in the military setting could result in organ injuries,which is uncommon and has been rarely described in previous studies.The aim of this study is to observe whether serum zinc le...Background:White smoke bomb exposure in the military setting could result in organ injuries,which is uncommon and has been rarely described in previous studies.The aim of this study is to observe whether serum zinc levels are associated with liver function after white smoke inhalation.Methods:Fifteen patients with white smoke exposure were the subjects in this study.The clinical manifestations,liver function tests and the serum zinc levels were analysed.Results:The level of serum zinc was increased in the moderate or severe group(n=4)compared with that in the mild group(n=11).The four cases in the moderate or severe group had delayed impairment of liver function with an elevation of alanine transaminase.Additionally,increased blood concentrations of hyaluronic acid were found in three patients in the moderate or severe group.But no hexachloroethane or trichloropropane was detected.Conclusion:This study suggested that serum zinc levels may be associated with the severity of liver injuries after white smoke inhalation.展开更多
文摘Liver transplantation has been reported in the literature as an extreme intervention in cases of severe and complicated hepatic trauma.The main indications for liver transplant in such cases were uncontrollable bleeding and postoperative hepatic insufficiency.We here describe four cases of orthotopic liver transplantation after penetrating or blunt liver trauma.The indications were liver failure,extended liver necrosis,liver gangrene and multiple episodes of gastrointestinal bleeding related to portal hypertension,respectively.One patient died due to postoperative cerebral edema.The other three patients recovered well and remain on immunosuppression.Liver transplantation should be considered as a saving procedure in severe hepatic trauma,when all other treatment modalities fail.
文摘Liver is one of the organs with the highest injury rate, and in recent decades, the guidelines for the treatment of liver trauma have changed considerably. Now, there is a growing consensus that the most important step is diagnosis and depending upon the degree of severity, non-operative therapy is the main treatment method for hepatic trauma if conditions permit. For serious hepatic trauma patients such as those with hemodynamic instability, they should be operated upon as soon as possible. Regardless of the surgical options, doctors should control damage to patients and try to prevent complications. New therapies such as hepatic artery embolization and liver transplantation have been more and more used for the treatment of serious heoatic damage in clinics.
文摘To probe into effective surgical procedures and improve the outcome of treatment for patients with severe hepatic injury. Methods: A retrospective study involving 113 patients with seve re hepatic trauma (AAST grade IV and V) during the past 12 years was carried out . Ninety eight patients underwent surgical treatment. Surgical interventions in cluding hepatectomy or direct control of bleeding vessels by finger fracture tec hnique with Pringle maneuver, selective ligation of hepatic artery, retrohepatic caval repair with total hepatic vascular occlusion, and perihepatic packing wer e mainly used. Results: In the 98 patients treated operatively, the survival r ate was 69.4 % (68/98). Among 40 patients with juxtahepatic venous injury (JH VI), 15 were cured with the maximum blood transfusion of 12 000 ml. Eight ca ses of Grade IV injury treated nonoperatively were cured. The percentage of fail ure of nonoperative management was 42.9 % (6/14). The overall mortality rate was 32.7 % (37/113), and 57% of the deaths were due to exsanguination. Conclusions: Reasonable surgical procedures based on classifica tion of hepatic injuries can increase the survival rate of severe liver trauma. Accurate perihepatic packing is effective in dealing with JHVI.
基金covered by the Chinese PLA General Hospital,where the study was conducted.
文摘Background:White smoke bomb exposure in the military setting could result in organ injuries,which is uncommon and has been rarely described in previous studies.The aim of this study is to observe whether serum zinc levels are associated with liver function after white smoke inhalation.Methods:Fifteen patients with white smoke exposure were the subjects in this study.The clinical manifestations,liver function tests and the serum zinc levels were analysed.Results:The level of serum zinc was increased in the moderate or severe group(n=4)compared with that in the mild group(n=11).The four cases in the moderate or severe group had delayed impairment of liver function with an elevation of alanine transaminase.Additionally,increased blood concentrations of hyaluronic acid were found in three patients in the moderate or severe group.But no hexachloroethane or trichloropropane was detected.Conclusion:This study suggested that serum zinc levels may be associated with the severity of liver injuries after white smoke inhalation.
