الفهرس 
Hepatic surgical anatomyOnly 14 pages are availabe for public view
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Abstract
This work aims to discuss the recent management of liver trauma with emphasis on cirrhotic patients.
The liver is the largest solid abdominal organ with a relatively fixed position, which makes it prone to injury. Damage to the liver is the most common cause of death after abdominal injury. The most common cause of liver injury is blunt abdominal trauma, which is secondary to motor vehicle crashes (MVC).
Hepatic trauma represents a significant management challenge that requires a high index of suspicion, rapid investigation, accurate classification and well-defined management protocols.
Imaging techniques especially Computerised Tomographic Scan (CT) has created remarkable impact in managing liver trauma patients by reducing the number of laparotomies.
Non operative management (NOM) of liver injury has generally become the most frequent treatment although urgent surgery continues to be the standard for hemodynamically compromised patients.
Hepatic cirrhosis: a kind of pathological changes in liver. Hepatic cirrhosis is frequently followed by hepatocellular necrosis. The predominant histological features are wide-spread fibrosis and nodule formation with loss of normal hepatic architecture. These changes are manifested clinically as hepatic failure and portal hypertension, the magnitude of which determines the course and prognosis of individual patients.
The impact of cirrhosis on trauma patients has recently been addressed. Thirty percent of trauma patients with pre-existing liver disease have an increased risk of death and an increased time of hospital stay.
Cirrhotic patients often suffer from complications. Cirrhosis impairs nutrition, alters response to stress, and affects the functions of other organ systems.
Cirrhotic patient with trauma cause unique problems and challenges to the trauma surgeon, especially in abdominal traumas requiring emergent laparotomy.
Cirrhotic patient with blunt abdominal trauma would result in high operative rate, low salvage rate of nonoperative management, high surgical mortality and morbidity rate.
Early detection of cirrhosis in trauma patient, early and aggressive correction of coagulation parameters, and early appropriate nutritional support will improve the management of liver trauma in cirrhotic patient.
The outcomes of patients with cirrhosis who undergo surgery could be improved by early preoperative management of comorbidities in cirrhotic patients, proper surgical techniques and anesthetic care, careful postoperative follow up and monitoring.