RESUMO
Hepatic trauma is a common cause for admissions in the Emergency Room. Currently, non-surgical management is the standard treatment in haemodynamically stable patients with a success rate of around 85 to 98%. This haemodynamic stability is the most important factor in selecting the appropriate patient. Adjuncts in non-surgical management are angioembolisation, image-guided drainage and endoscopic retrograde cholangiopancreatography. Failure in non-surgical management is relatively rare but potentially fatal, and needs to be recognised and aggressively treated as early as possible. The main cause of failure in non-surgical management is persistent haemorrhage. The aim of this paper is to describe current evidence and guidelines that support non-surgical management of liver injuries in blunt trauma.
Assuntos
Traumatismos Abdominais/terapia , Fígado/lesões , Ferimentos não Penetrantes/terapia , Traumatismos Abdominais/fisiopatologia , Colangiopancreatografia Retrógrada Endoscópica , Gerenciamento Clínico , Drenagem , Embolização Terapêutica , Emergências , Hemodinâmica , Hemorragia/etiologia , Hemorragia/terapia , Técnicas Hemostáticas , Humanos , Fígado/fisiopatologia , Guias de Prática Clínica como Assunto , Ferimentos não Penetrantes/fisiopatologiaRESUMO
Extreme violence events are consequence of current world-wide economic, political and social conditions. Injury patterns found among victims of extreme violence events are very complex, obeying several high-energy injury mechanisms. In this article, we present the basic concepts of trauma kinematics that regulate the clinical approach to victims of extreme violence events, in the hope that clinicians increase their theoretical armamentarium, and reflecting on obtaining better outcomes.