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Treatment of Liver Injuries: An Overview

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Operative Techniques for Severe Liver Injury

Abstract

The liver is the largest organ in the body and the organ most frequently injured. This is true for both blunt and penetrating wounds. The morbidity and mortality associated with liver injury vary with the associated hemorrhagic shock insult, the severity of liver injury as judged by the Abbreviated Injury Score (AIS), and the presence or absence of bleeding at the time of operative intervention. The severity of injury related to missile wounds correlates directly with the amount of energy that is dissipated as the missile traverses the liver, with the energy being calculated by the classic formula of energy = mass × volume 2 ÷ 2. Thus, high velocity missiles have the greatest potential for creating the worst injuries. When a patient with a liver injury presents with severe hemorrhagic shock that is not rapidly reversible with preoperative resuscitation, the mortality is very high; when the hemorrhagic shock insult is corrected while in transit to the operating room, the mortality is low; when there is no associated hemorrhagic shock, the mortality is negligible.

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Author information

Authors and Affiliations

  1. Department of Surgery, Wayne State University, 4201 St. Antoine Street, Room 2V, Detroit, MI, 48201, USA

    Charles E. Lucas MD

  2. Department of Surgery, Detroit Receiving Hospital, 4201 St. Antoine Street, Room 2V, Detroit, MI, 48201, USA

    Anna M. Ledgerwood MD

Authors
  1. Charles E. Lucas MD
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  2. Anna M. Ledgerwood MD
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Corresponding author

Correspondence to Charles E. Lucas MD .

Editor information

Editors and Affiliations

  1. Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA

    Rao R. Ivatury

Video Captions

Initial hemorrhage control (MOV 48398 kb)

Liver suture (MOV 39685 kb)

Digital compression (MOV 16750 kb)

Case 01. A 16-year-old boy was a victim of gunshot wound through the right flank (MOV 35988 kb)

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Lucas, C.E., Ledgerwood, A.M. (2015). Treatment of Liver Injuries: An Overview. In: Ivatury, R. (eds) Operative Techniques for Severe Liver Injury. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1200-1_2

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  • DOI: https://doi.org/10.1007/978-1-4939-1200-1_2

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1199-8

  • Online ISBN: 978-1-4939-1200-1

  • eBook Packages: MedicineMedicine (R0)

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