Traumatismo hepático por coz de caballopresentación de dos casos

  1. R. Latorre-Fragua 1
  2. A. Manuel-Vázquez 1
  3. L. Gijón-de la Santa 1
  4. R. de la Plaza-Llamas 1
  5. J.M. Ramia-Ángel 1
  1. 1 Hospital Universitario de Guadalajara. Guadalajara
Revista:
Cirugía Andaluza

ISSN: 2695-3811,  1130-3212

Any de publicació: 2017

Volum: 28

Número: 4

Pàgines: 282-284

Tipus: Article

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Altres publicacions en: Cirugía Andaluza

Resum

Equestrian sports may carry a risk of liver injury. Horse kick injuries usually occur when rides are dismounted, most frequently when grooming without wearing protective equipment. Equine-associated liver injuries are not well studied due to the relative infrequency of these patients. Some of these patients needs surgery to repair liver injuries but most of them can be management with close observation. We present two cases of hepatic trauma due to equine injury. 21-year-old-female, abdominal pain after being kicked by a horse in the right side of the abdomen. Haemodynamic instability with initial response to volume. CT: laceration grade IV of the right liver (AAST scale) and hemoperitoneum. Laparotomy was performed and a resection of segment VI was carried. No more abdominal injuries were found. The patient was discharged after 6 days, without complications. 51-year-old-male, costal and abdominal pain in the right upper quadrant after a horse kick. Haemodynamic stability. CT: Liver laceration of the IV,V and VI segments (AAST scale) and 9th costal arch fracture. Conservative management was carried out with good evolution. Liver injuries in equestrian accidents should be suspected and carefully managed. When haemodynamic instability appears, surgical intervention is mandatory for bleeding control. If there is no instability, conservative management could be taken. Radiological intervention such as embolization is an increasingly viable alternative in the non-operative management in stable patients.

Referències bibliogràfiques

  • Balakrishnan A, Abbadi R, Oakland K, Jamdar S, Harper SJF, Jamieson NV et al. Outcomes following liver trauma in equestrian accidents. J Trauma Manag Outcomes. 2014; 8: 13.
  • Ball CG, Ball JE, Kirkpatrick AW, Mulloy RH: Equestrian injuries: incidence, injury patterns, and risk factors for 10 years of major traumatic injuries. Am J Surg 2007; 193: 636-640.
  • Papachristos A, Edwards E, Dowrick A, Gosling C: A description of the severity of equestrian-related injuries (ERIs) using clinical parameters and patient-reported outcomes. Injury 2014; 45: 1484-1487.
  • Muñiz Fontán M, Moure González J.D, Mirás Veiga A, Rodriguez Nuñez A. Accidentes graves provocados por caballos. Alertas y pautas de prevención. An Pediatr (Barc) 2009; 70:434-437.
  • Lübek T, Kulesza T, Jojczuk M,Ochal A, Olszewski G, Prystupa A, Nogalski A. Blunt abdominal trauma from horse kicks. J Pre-Clin Clin Res 2013; 7:59-62.
  • Exadaktylos AK, Eggli S, Inden P, Zimmermann H. Hoof kick injuries in unmounted equestrians. Improving accident analysis and prevention by introducing an accident and emergency based relational database. Emerg Med J 2002; 19:573-575.
  • Eckert V, Ute Lockemann U, Klaus Pu¨schel K, Meenen NM, Hessler C. Equestrian injuries caused by horse kicks: First results of a prospective multicenter study. Clin J Sport Med 2011; 21: 353–5.
  • Prichayudh S, Sirinawin C, Sriussadaporn S, Pak-art R, Kritayakirana K, Samorn P, Sriussadaporn S. Management of liver injuries: predictors for the need of operation and damage control surgery. Injury 2014 Sep;45(9):1373-7.
  • Petrowsky H, Raeder S, Zuercher L, Platz A, Simmen HP, Puhan MA et al. A quarter century experience in liver trauma: a plea for early computed tomography and conservative management for all hemodynamically stable patients. World J Surg 2012: 36:247–254.
Fuente de los datos: Dialnet