Profils clinico-évolutifs de 45 patients opérés pour traumatisme hépatique

Boukrissa, Merouane; Brahmi, Khadidja; Ayad, Anwar; Rahmet Melaizi, Nasreddine; Bendjeriou, Amel; Belaid, Abdelkrim

Journal de la Faculté de Médecine
Volume 3, Numéro 7, Pages 481-488
2019-12-30

Profils Clinico-évolutifs De 45 Patients Opérés Pour Traumatisme Hépatique

Auteurs : Boukrissa Merouane . Brahmi Khadidja . Ayad Anwar . Rahmet Melaizi Nasreddine . Bendjeriou Amel . Belaid Abdelkrim .

Résumé

Abstract Introduction - The management of hepatic trauma has evolved considerably in recent years and therapeutic attitudes are becoming more and more conservative. The objective of our study was to identify the different diagnostic criteria that established the operative indication as well as the therapeutic and evolutionary aspects of patients operated on for liver injury following a trauma. Results - The average age of operated patients was 30.63 years with extremes from 16 to 89. There is a clear male predominance with 89% of cases. Closed trauma to the abdomen (ASD) was found in 64.4% of cases and penetrating wounds in the abdomen in 35.6% of cases. Hemodynamic instability from the outset with administration of hemodynamic supports was present in 37.7% of the cases and required surgical exploration. Associated extra abdominal lesions were frequent with 26.6% of cases of head trauma, 17.7% of cases of hemopneumothorax, one case of hemo-mediastinum, 11.1% of cases of trauma to the spine and 17.7 % of femur fractures. Discussion - The persistence of hemodynamic instability despite the filling measures conditions the decision to take surgical treatment. Any delay in performing the laparotomy represents a loss of luck and impacts the mortality rate. Conclusion - The prognosis for liver damage during trauma to the abdomen differs depending on the severity of the injury and its haemorrhagic nature. The existence of a hemorrhagic shock and the association of intra and / or extra abdominal lesions condition the prognosis of this type of trauma.