Liver Trauma Essay
Diagnosis:
Physical symptoms of liver trauma include blood loss, tenderness of the region, peritoneal irritation and its guarding. Haemodynamically stable patients with suspected live injury should be investigated for imaging studies.
Focused Assessment with Sonography in Trauma (FAST) is usually useful for both blunt and penetrating trauma. FAST has sensitivity from 75-94 % and specificity from 97-100 % for intra-abdominal fluid in trauma patients. FAST cannot distinguish between laceration and haematomas, also it cannot detect injuries at the lateral part of the liver, retroperitonial injuries and hollow viscus injuries. As compared to the non-contrast sonography, contrast enhanced ultrasonography has more advantages in terms of visibility, …show more content…
MRI is useful for the follow-up of the blunt liver trauma.
Angiography is specifically useful in the patients with stable liver trauma. Angiography is required in cases of extravasation of contrast on CT scan, which also detects exact location of bleeding. Sensitivity of angiogram is 75 % and specificity is 70- 93%. Angiography and angioembolization together is beneficial in case of rebleeding is suspected patients [10]-[11] (Carrillo, 1999; Ciraulo, 1998).
For diagnosis purpose, laparoscopy can be used for the evaluation of diaphragm rupture and free blood in case of liver trauma. For therapeutic purpose, laparoscopy can be used for repair of the diaphragm. For liver trauma, laparoscopy has the 92 % sensitivity and 100 % specificity. Hemodynamic disturbance due to the liver trauma prevents the regular use of laparoscopy for liver trauma [12]-[13] (NABIL, 2012;Ivatury, 1993).
Diagnostic peritoneal lavage (DPL) is the oldest method for detecting bleeding in liver trauma patients. DPL can be used for both blunt and penetrating liver trauma. Due to invasive nature of this method, it has been replaced by other methods in recent
Physical symptoms of liver trauma include blood loss, tenderness of the region, peritoneal irritation and its guarding. Haemodynamically stable patients with suspected live injury should be investigated for imaging studies.
Focused Assessment with Sonography in Trauma (FAST) is usually useful for both blunt and penetrating trauma. FAST has sensitivity from 75-94 % and specificity from 97-100 % for intra-abdominal fluid in trauma patients. FAST cannot distinguish between laceration and haematomas, also it cannot detect injuries at the lateral part of the liver, retroperitonial injuries and hollow viscus injuries. As compared to the non-contrast sonography, contrast enhanced ultrasonography has more advantages in terms of visibility, …show more content…
MRI is useful for the follow-up of the blunt liver trauma.
Angiography is specifically useful in the patients with stable liver trauma. Angiography is required in cases of extravasation of contrast on CT scan, which also detects exact location of bleeding. Sensitivity of angiogram is 75 % and specificity is 70- 93%. Angiography and angioembolization together is beneficial in case of rebleeding is suspected patients [10]-[11] (Carrillo, 1999; Ciraulo, 1998).
For diagnosis purpose, laparoscopy can be used for the evaluation of diaphragm rupture and free blood in case of liver trauma. For therapeutic purpose, laparoscopy can be used for repair of the diaphragm. For liver trauma, laparoscopy has the 92 % sensitivity and 100 % specificity. Hemodynamic disturbance due to the liver trauma prevents the regular use of laparoscopy for liver trauma [12]-[13] (NABIL, 2012;Ivatury, 1993).
Diagnostic peritoneal lavage (DPL) is the oldest method for detecting bleeding in liver trauma patients. DPL can be used for both blunt and penetrating liver trauma. Due to invasive nature of this method, it has been replaced by other methods in recent