This journal is
indexed in Scopus

Year 2012 Vol. 20 No 1




Technical University of Munich 1, Munich,
ME Vitebsk regional clinical hospital 2,
The Republic of Belarus,
Philipps-University of Marburg 3, Marburg,

Actual problems of medical aid rendering to the patients with the abdominal trauma accompanied by the liver parenchema damage at the prehospital and hospital stages are studied in the article. Abdominal trauma at the isolated and accompanying liver damage depending on the severity stage of parenchema damage demands differentiated treatment; it includes not only a conservative therapy but also surgical actions such as surface bleeding stopping, compression techniques(packing and mesh-wrapping) up to the atypical and anatomical liver resection. Total hepatectomy with subsequent liver transplantation is the reasonable method of treatment at massive irreversible liver parenchema damage. This method should be applied only in specialized centers in case the indications are present.

Keywords: abdominal trauma, liver damages, aid rendering, liver transplantation
p. 115 119 of the original issue

1.Bardenheuer M, Obertacke U, Waydhas C, Nast-Kolb D. Epidemiology of the severely injured patient. A prospective assessment of preclinical and clinical management. AG Polytrauma of DGU. Unfallchirurg. 2000 May;103(5):35563. [Article in German]
2.Demetriades D, Kuncir E, Brown CV, Martin M, Salim A, Rhee P, Chan LS. Early prediction of mortality in isolated head injury patients: a new predictive model. J Trauma. 2006 Oct;61(4):86872.
3.Nast-Kolb D, Waydhas C, Kastl S, Duswald KH, Schweiberer L. Stellenwert der Abdominalverletzung fur den Verlauf des Polytraumatisierten. [The role of an abdominal injury in follow-up of polytrauma patients]. Chirurg. 1993 Jul;64(7):55259. [Article in German]
4. Enderson BL, Maul KI. Missed inuries: the trauma surgeons nemesis. Surg Clin North Am. 1991;71:39917.
5.Reed RL 2nd, Merrell RC, Meyers WC, Fischer RP. Continuing evolution in the approach to severe liver trauma. Ann Surg. 1992 Nov;216(5):52438.
6.Kirchhoff C, Stegmaier J, Krotz M, Muetzel Rauch E, Mutschler W, Kanz KG, Heindl B. Celiac dissection after blunt abdominal trauma complicated by acute hepatic failure: case report and review of literature. J Vasc Surg. 2007 Sep;46(3):576-80.
7.Ott R, Schon MR, Seidel S, Schuster E, Josten C, Hauss J. Surgical management, prognostic factors, and outcome in hepatic trauma. Unfallchirurg. 2005 Feb;108(2):12734. [Article in German]
8.Guidelines 2000 for resuscitation and emergency cardiovascular care: cardiac arrest associated with trauma; Am Heart Assoc Resuscitation. 2000;46:28992.
9.Maghsudi M, Nerlich M. Polytrauma. Internist. 1998; 39:18894.
10.Deutsche Stiftung fur Organstransplantation. Jahresbericht [Electronic recourse]. 2006. Mode of access:
11.Trawen A, Maraste P, Persson U. International comparison of costs of a fatal casuality of road accidents in 1990 and 1999. Accident Analysis & Prevention. 2002;34:32332.
12.Noris FH, Matthews BA, Riad JK. Characterological, situational and behavioural risk factors for motor vehicle accidents: a prospective examination. Accident Analysis & Prevention. 2000;32:50515.
13.Angstadt J, Jarell B, Carabasi A. Liver transplantation following severe liver trauma. Transplantation. 1988;46:32122.
14.Rogers FB, Osler TM, Shackford SR, Cohen M, Camp L, Lesage M. Study of the outcome of patients transferred to a level I hospital after stabilisation at an outlying hospital in a rural setting. J Trauma. 1999 Feb;46(2):32833.
15. Oestern HJ, Kabus K. Klassifikation Schwerund Mehrfachverletzter was hat sich bewahrt? Chirurg. 1997;68:105965.
16.Brunet C, Sielezneff I, Thomas P, Thirion X, Sastre B, Farisse J. Treatment of hepatic trauma with perihepatic mesh: 35 cases. J Trauma. 1994 Aug;37(2):200204.
17.Boggi U, Vistoli F, Del Chiaro M, Signori S, Sgambelluri F, Roncella M, Filipponi F, Mosca F. Extracorporeal Repair and Liver Autotransplantation after Total Avulsion of Hepatic Veins and Retrohepatic Inferior Vena Cava Injury Secondary to Blunt Abdominal Trauma. J Trauma. 2006 Feb;60(2):40506.
18.Nast-Kolb D, Waydhas C, Kanz KG, Schweiberer L. Algorithmus fur das Schockraummanagement fur beim Polytrauma [An algorithm for management of shock in polytrauma].Unfallchirurg. 1994 Jun;97(6):292302. [Article in German]
19.Esquivel CO, Benrnardos A, Makowka L. Liver replacement after massive hepatic trauma. J Trauma.1987;27:800802.
20.Sung CK, Kim K H. Missed injuries in abdominal trauma. J Trauma 1996;41(2):27682.
21.Haas NP, von Fournier C, Tempka A, Sudkamp NP. Traumazentrum 2000: Wieviele und welche Traumazentren braucht Europa um das Jahr 2000? [Trauma center 2000. How many and which trauma centers does Europe need around the year 2000?].Unfallchirurg. 1997 Nov;100(11):85258. [Article in German]
22.Nast-Kolb D, Trupka A, Ruchholtz S, Schweiberer L. bdominaltrauma. Unfallchirurg. 1998;101:8291.
23.Moore E. Critical decisions in the management of hepatic trauma. Am J Surg. 1984;148: 71216.
24.Cogbill TH, Moore EE, Jurkovich GJ, Feliciano DV, Morris JA, Mucha P. Severe hepatic trauma: a multi-centre experience with 1335 liver injuries. J Trauma. 1988 Oct;28(10):143338.
25.Veroux M, Madia C, Cillo U, Brolese A, Zanus G, Fiamingo P, Veroux P, D'Amico DF. Long-term follow-up after liver transplantation for blunt hepatic trauma. Transplant Proc. 2002 Jun;34(4):122628.
26.Ringe B, Pichlmayr R, Ziegler H, Grosse H, Kuse E, Oldhafer K, Bornscheuer A, Gubernatis G. Management of severe hepatic trauma by two-stage total hepatectomy and subsequent liver transplantation. Surgery. 1991 Jun;109(6):7925.
27. Veroux M, Cillo U, Brolese A, Veroux P, Madia C, Fiamingo P, Zanus G, Buffone A, Gringeri E, D'Amico DF. Blunt liver injury: from non-operative management to liver transplantation. Injury. 2003 Mar;34(3):18186.
28.Ringe B, Lubbe N, Kuse E, Frei U, Pichlmayr R. Total hepatectomy and liver transplantation as two-stage procedure. Ann Surg. 1993 Jul;218(1):39.

Address for correspondence:
Dr. Edouard Matevossian, MD,
Klinikum rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany,
Information about the authors:
Matevosyan E. Privatdozent, MD, Department of surgery and transplantation of Clinic, "Rehts der Isar of Technical University of Munich.
Maak M. Doctor of medicine, Department of surgery of Clinic, "Rehts der Isar of Technical University of Munich.
Sapko G.V. Surgeon, ME Vitebsk regional clinical hospital.
Friss H. Professor, Doctor of medicine, Department of surgery of Clinic, "Rehts der Isar of Technical University of Munich.
Doll D.Privatdozent, MD, Department of visceral, vascular and thoracic surgery, Philipps-University of Marburg.
Contacts | ©Vitebsk State Medical University, 2007