A case report of blunt liver trauma in times of COVID-19 pandemic

V. Braga, I. Slavu, A. Tulin, B. Socea, L. Alecu
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Abstract

Abstract The liver is one of the most affected organs in abdominal trauma mostly because of its considerable dimensions, the fragility of the liver parenchyma. We present the case of a 29-year-old patient who sustained an abdominal trauma after an accidental fall from a 3 m height. The patient tested positive at RT-PCR for SARS-CoV-2 at admission, without any symptoms of viral infection. The emergency CT scan revealed a blunt liver trauma with an expanding hematoma (grade III). The patient was initially hemodynamically stable but shortly after admission became unstable and required surgical treatment that initially consisted of damage control and liver packing. Reintervention was decided 36 hours later, after reevaluation unpacking and hepatorrhaphy were done. The postoperative evolution was uneventful. The case indicated the importance of continuous monitoring of the traumatic patient. In liver trauma, hemodynamic instability guarantees an emergency laparotomy. The time of operations in trauma patients with SARS-CoV-2 must be reduced to the maximum both as an objective of damage control and also to minimize the risk of contagion.
新冠肺炎大流行期间钝性肝损伤1例报告
摘要肝脏是腹部创伤中受影响最大的器官之一,主要是由于其相当大的体积和肝实质的易碎性。我们提出的情况下,一个29岁的病人谁持续从3米高意外坠落后腹部创伤。患者入院时RT-PCR检测SARS-CoV-2阳性,无任何病毒感染症状。急诊CT扫描显示钝性肝损伤伴扩大血肿(III级)。患者最初血流动力学稳定,但入院后不久变得不稳定,需要手术治疗,最初包括损伤控制和肝脏填塞。36小时后,在重新评估、开封和肝缝合后决定再次介入治疗。术后进展顺利。该病例表明了对创伤患者进行持续监测的重要性。在肝外伤中,血流动力学不稳定保证了紧急剖腹手术。必须最大限度地缩短创伤患者的手术时间,这既是为了控制损害,也是为了尽量减少传染风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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