(Disclaimer: This article is for scientific use only, and the information in the following content has been processed to protect patient privacy)
Abstract: The patient was admitted to the hospital for a car accident injury, which caused a right hepatic site compression, thus leading to liver rupture with intra-abdominal hemorrhage, and came to the hospital in very poor spirits and already in hemorrhagic shock. The patient was found to be in critical condition with serious liver rupture and intra-abdominal bleeding through emergency CT. We urgently performed a dissection for the patient and performed hemostasis and repair of the liver contusion, and due to timely treatment, the patient eventually turned to safety.
Basic information】Male, 36 years old
Disease Type】Liver contusion
Hospital】Liaocheng People’s Hospital
Date of consultation】November 2021
Treatment plan】Surgical treatment (liver necrotic tissue removal + suture haemostasis)
Treatment Period】Hospitalization for half a month, regular follow-ups
Treatment effect】Surgery went smoothly, out of life-threatening condition, good recovery after surgery
I. Initial consultation
The patient, Mr. Wang, was injured in a car accident caused by a collision between two cars due to fatigue while driving. The patient’s right side of the liver was crushed and was brought to our hospital by 120 for emergency treatment. When he entered the emergency room, the patient had already shown signs of shock such as increased heart rate and low blood pressure, and a rapid emergency abdominal CT indicated that the patient had liver rupture and intra-abdominal hemorrhage, which could endanger the patient’s life at any time. As the patient’s condition was urgent, in order to save the patient’s life, after obtaining the consent of the family, the patient was urgently operated by caesarean section.
II. Treatment process
After entering the operating room, we first gave the patient an emergency blood transfusion, and then performed a dissection under anesthesia. We found that the patient’s right liver was severely fragmented after the impact, and some of the thicker blood vessels were ruptured, causing intra-abdominal hemorrhage. We urgently removed the broken and necrotic tissues from the abdominal cavity, and repaired and sutured the ruptured blood vessels. After 2 hours of struggle, the active bleeding in the patient’s abdominal cavity was finally stopped, and the vital signs gradually recovered steadily.
The whole operation went very smoothly, with a total of 2000 ml of intraoperative bleeding. After the operation, the patient would be sent to the intensive care unit, and after 2 days of intensive care treatment, the patient turned from coma to normal and was more conscious, and his condition tended to stabilize, so he was transferred to the general ward. Half a month after the operation, after active postoperative recovery treatment, the patient’s surgical incision did not show obvious blood and exudate, no signs of infection, and gradually transitioned from a liquid diet to a normal diet, consciousness remained awake, pain at the incision gradually reduced, and reached the discharge criteria, so he was allowed to be discharged for recuperation.
III. Treatment effect
Due to timely diagnosis of the disease and timely surgery, the patient’s life was prevented from being endangered by intra-abdominal hemorrhage, and the patient’s life was saved, and a family was saved. The precise operation during surgery and professional rehabilitation after surgery also ensured that the patient had no postoperative complications and recovered smoothly. In addition, the patient was a young and strong male with good health, and after active postoperative treatment, he reached the discharge standard half a month after surgery and was successfully discharged from the hospital.
IV. Notes
We are glad that after treatment, the patient is out of life threatening condition and recovered well after surgery. However, the patient may have anemia due to hemorrhage caused by liver contusion. Therefore, after the patient can eat normally, he needs to increase nutrition to ensure the necessary nutrients for his body. Patients can increase their daily intake of protein, such as fish, shrimp, eggs and milk, and also eat more iron-supplemented foods, which can promote the regeneration of hemoglobin.
In addition, patients need to be reviewed regularly after discharge from the hospital. Generally, it is necessary to review 1 month after discharge to prevent the rupture injury of the liver and also the damage of important ducts, which may lead to the damage of liver function or tissues in a certain liver region and thus cause the corresponding complications.
V. Personal insight
The patient in this article was involved in a car accident caused by fatigue driving, which subsequently caused liver rupture. Modern life is fast-paced, and the pressure of life for everyone is gradually increasing, and many times there is overload. However, no matter what time it is, you should keep in mind not to drive fatigued. Most of the injuries caused by car accidents are serious, and some may even be life-threatening, so extra attention needs to be paid to safe driving. In addition, in the case of serious trauma, you should try to go to a larger emergency center, which is more helpful in determining certain conditions, as well as for the treatment of certain conditions.