In addition to hemorrhage, which is one of the most well-known factors, there are many other causative factors for serious hypotension after hepatic trauma. In this report, we present patients with persistent cardiac depression after perihepatic packing due to high grade liver injury and report on treatment modalities, including the early second-look procedure. Three patients with isolated hepa...

R,S-4'-Methyl-alpha-pyrrolidinohexanophenone (MPHP) is a new designer drug which has appeared on the illicit drug market. The aim of this study was to identify the MPHP metabolites using solid-phase extraction, ethylation or acetylation, as well as to develop a toxicological detection procedure in urine using solid-phase extraction, trimethylsilylation and GC-MS. Analysis of urine samples of ra...

BACKGROUND Hemorrhage is the leading cause of preventable posttraumatic death. Many such deaths may be potentially salvageable with remote damage-control surgical interventions. As recent innovations in information technology enable remote specialist support to point-of-care providers, advanced interventions, such as remote damage-control surgery, may be possible in remote settings. METHODS A...

We report the case of a young trauma patient who needed tight perihepatic surgical packing to control bleeding from a ruptured liver. He developed severe cardiovascular and respiratory decompensation on removal of the surgical packs as a result of the post-reperfusion syndrome. He underwent a total hepatectomy and, 35 h later, orthotopic liver transplantation. The pathophysiology of post-reperf...

141 show that surgery is still the best treatment in many instances in terms of quality of the results, cost and rapid rehabilitation compared to non surgical methods such as interventional radiology or "operative" endoscopy. (1981) Les traumatismes operatoires de la voie biliaire principale. Monographie de l'Association Franaise de Chirurgie (AFC). Masson 2. Hepp, J. (1985) Hepaticojejunostomy...

OBJECTIVE To document and analyse the presentation and outcome of surgical management of liver trauma. METHODS The study was a retrospective review of records of all surgeries carried out at the Department of General Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from January 2003 to December 2010. The study included all adult patients of either gender who presented with l...

INTRODUCTION Hemangioma is the most frequent benign solid tumor of the liver. It is well known that a giant liver hemangioma carries the risk of spontaneous rupture, followed by hemoperitoneum and hemorrhagic shock with possible fatal outcome. CASE OUTLINE This is a case report of the spontaneous rupture of a giant cavernous hemangioma of the liver in an 85-year old patient.The patient was pr...

BACKGROUND With an increasing incidence of road traffic accidents and weapon injuries there is increasing need for improvement in trauma management. Liver being a highly vascular organ and strategically located is difficult to manage. METHODS Study was conducted in Surgical 'A' Unit, Lady Reading Hospital, Peshawar from August 2003 to September 2005. It was a descriptive study and all patient...

Mortality remain high for patients with complex hepatic injuries rades IV and V however numerous studies have shown improved utcomes with a multidisciplinary approach using a combination f angioembolization, perihepatic packing and resection. Patients ith a transplanted liver allograft pose an additional challenge as his is a rare occurrence only reported once in the literature. We eport a case...

BACKGROUND Despite continuous advances in traumatology, juxtahepatic venous injuries are still the most difficult and deadly form of liver trauma. Most deaths result from exsanguination, and reported mortality ranges from 50% to 80%. This is an evaluation on our experience with the management of this high mortality injury following a refined operative strategy. METHODS This is a retrospective...