Bursting injuries of the liver. A complex surgical challenge.

BURSTING injuries of the liver present one of the most challenging problems encountered in the field of surgery. When a sudden, severe force is applied to a fluidfilled, sinusoidal, encapsulated mass, the force is dissipated as hydrokinetic energy and to a certain extent is governed by Pascal's principle, ie, it is transmitted in all directions and acts with the same force on all equal surfaces. A turgid organ, such as the liver, responds by bursting with an explosive violence that severely damages the internal architecture and manifests itself on various surfaces by stellate or linear crevasses. This kind of injury of the liver is unique and presents certain problems that are entirely different from those encountered in most liver injuries. The burst injury is characterized by profound shock, profuse hemorrhage, massive hemoperitoneum, pulpefaction of liver parenchyma, extravasation of bile, and metabolic and hematologic deficiencies. Multiple skeletal and soft tissue trauma

[1]  R. McClelland,et al.  Management of Liver Trauma in 259 Consecutive Patients , 1965, Annals of surgery.

[2]  G. Shaftan,et al.  Injuries of the liver: a review of 111 cases. , 1963, The Journal of trauma.

[3]  F Glenn,et al.  Graded trauma in liver injury. , 1966, The Journal of trauma.

[4]  Mcafee Dk,et al.  Emergency hepatic lobectomy in massive injury of the liver. , 1961 .

[5]  Healey Je.  Clinical anatomic aspects of radical hepatic surgery. , 1954 .

[6]  P. H. Thorlakson,et al.  Rupture of the Liver. , 1929, Canadian Medical Association journal.

[7]  J. Goodman,et al.  Treatment of Exsanguinating Rupture of the Right Lobe of the Liver by Ligation of the Main Hepatic Artery: Case Report , 1965, Annals of surgery.

[8]  E. M. Mcfetridge,et al.  AUTOLYSIS OF TISSUE IN VIVO: AN EXPERIMENTAL STUDY WITH ITS CLINICAL APPLICATION IN THE PROBLEM OF TRAUMA TO THE LIVER , 1937 .

[9]  F. C. Helwig,et al.  LIVER TRAUMA AND THE HEPATORENAL SYNDROME , 1939, Annals of surgery.

[10]  G. Pack,et al.  Regeneration of human liver after major hepatectomy. , 1962, Surgery.

[11]  G. F. Madding.  Injuries of the liver. , 1955, A.M.A. archives of surgery.

[12]  D. Judd,et al.  Right hepatic lobectomy for massive liver trauma: case report. , 1966, Annals of surgery.

[13]  J. K. Quattlebaum.  Technic of Hepatic Lobectomy , 1959, Annals of surgery.

[14]  Goldsmith Na,et al.  The surgical anatomy pertaining to liver resection. , 1957 .

[15]  M. Fogelman,et al.  Wounds of the liver; review of 100 cases. , 1954, Annals of surgery.

[16]  T. Lin,et al.  Total right hepatic lobectomy for primary hepatoma. , 1960, Surgery.

[17]  E. Poulos,et al.  HEPATIC RESECTION FOR MASSIVE TRAUMA. , 1964, The Journal of trauma.

[18]  J. Martin.  Wounds of the liver. , 1947, Annals of surgery.

[19]  Healey Je,et al.  The intrahepatic distribution of the hepatic artery in man. , 1953 .

[20]  J. Vasko,et al.  Acute renal failure from massive intrahepatic hematoma compressing the inferior vena cava: recovery after right hepatic lobectomy. , 1966, Annals of Surgery.

[21]  Pringle Jh,et al.  NOTES ON THE ARREST OF HEPATIC HEMORRHAGE DUE TO TRAUMA , 1908 .