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Abstract: Liver contusion is a common clinical trauma to the liver, commonly caused by rupture of the liver due to various traumatic injuries, including being hit or injured in a car accident or falling by oneself. The patient in this case was injured by being hit, resulting in liver contusion. After examination, it was found that there was not much abdominal bleeding and the extent of liver tissue damage was small, and after conservative treatment with bed rest and thrombin hemostasis, the hematoma in the liver was completely absorbed and normal activities were resumed.
[Basic information] Female, 30 years old
Disease Type】Hepatic contusion, hematoma of the liver
Hospital】Liaocheng People’s Hospital
Consultation time】November 2021
Treatment plan】Bed rest + medication to stop bleeding (thrombin)
Treatment Period】2 weeks of hospitalization, review after half a month
Effectiveness】The liver contusion was completely healed, and the conservative treatment was successful, with no effect on normal life
I. Initial consultation
A young woman was injured by someone, mainly in the abdomen, especially in the right upper abdomen, and the pain could not be relieved, it was possible that the liver was injured, and the patient was given an abdominal CT in the emergency room. The liver function also indicated that the transaminases were significantly elevated, and the blood count indicated a mild decrease in hemoglobin, but the patient’s vital signs were relatively stable except for pain, so it was decided to admit the patient to the hospital first.
II. Treatment process
After admission, the patient was admitted to the monitoring room, where he was put on cardiac monitoring and his vital signs were strictly observed. If the blood pressure tended to drop and the heart rate increased, it generally indicated that the bleeding was relatively rapid or there was continued bleeding, and there was a possibility of emergency caesarean operation. And the patient was rechecked within a short period of time, and it was found that the routine hemoglobin did not change much. And the patient was also given an abdominal ultrasound examination in the ward, and it was found that there was no significant increase in the accumulation of blood in the patient’s abdominal cavity. This indicates that the patient does not have a large amount of intra-abdominal bleeding at present, but only a liver hematoma caused by liver contusion, and this hematoma is currently stable.
The patient’s condition was then communicated to the family that the patient now had a chance of conservative treatment and a better chance of success. The patient’s family also agreed to the treatment plan. Therefore, the main treatment plan at present is to be sure to rest in bed, reduce activity, and then use the hemostatic drug thrombin, while closely observing the patient’s vital signs. We have also communicated with the patient’s family that if the patient’s vital signs are not stable or if the bleeding worsens, emergency surgery may be performed at any time. Fortunately, the patient’s condition has been stable.
III. Treatment effect
After 1 week of treatment, the patient’s condition became more and more stable, the abdominal pain became less and less, and the patient was able to eat normally. A repeat abdominal CT showed that the extent of the hematoma on the liver also began to decrease, and there was no obvious bleeding in the abdominal cavity. After 2 weeks of treatment, the hematoma in the liver was completely absorbed and the patient resumed normal activities and life, and was discharged from the hospital. The patient was also instructed to come back to the hospital for a review in half a month.
IV. Notes
We are glad that the patient’s symptoms of liver contusion were completely relieved after conservative treatment. It is recommended that the patient should rest and avoid strenuous activities after discharge. The diet should be based on light and well-digested food, avoiding fried food, smoking and alcohol, and gradually transitioning to a normal diet. In daily life, patients should maintain a stable and good mood, and follow the doctor’s instructions for regular review, which will help the body recover.
V. Personal insight
In our life, abdominal trauma is a relatively common disease. If you feel severe abdominal pain after abdominal trauma, or appear weakness, etc., you must go to the hospital in time to avoid the situation of delaying the condition due to intra-abdominal organ damage. In case of liver contusion, conservative treatment or emergency surgery should be chosen depending on the patient’s bleeding and liver damage. Usually, in milder cases of liver contusion, as in this patient, the condition can mostly be effectively relieved by conservative treatment, but if the condition worsens, there is a possibility of performing a caesarean section at any time.