Causes and treatment of ruptured liver

Traffic accidents, falls, injuries in fights, blows during sports fighting fights – often all this ends with serious damage to the intestines. And most often the liver suffers under such circumstances. This organ is larger than many others, which is why it takes on most of these blows.

Most often, patients who receive a severe blow to the peritoneum are diagnosed with a ruptured liver. This traumatological pathology is extremely dangerous. If the patient is not provided with the necessary medical care in time, he may die.

How to understand that a person has just such an injury, what types of it are and how is this pathology treated?

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Causes

Liver rupture can occur under various circumstances. But the causes of the onset of pathology are almost always similar – it is some kind of strong blow or a long-term strong effect on the peritoneal area of ​​a person.

A blow to the liver, received, say, in the course of an ordinary household fight, a knife or bullet wound that was inflicted on a person during a street brawl – as a result of such circumstances, a traumatic rupture of an organ develops.

Liver contusion during a fall from a height gives the same complications. Moreover, it is not necessary for this to fall from a height of several floors, often just an unsuccessful landing is enough, for example, when skiing.

Participation in an accident, especially if this accident is a “pedestrian-car”, also, as a rule, ends with an injury to this largest gland associated with its rupture. Similar consequences are observed after a person has been in a compressed state for a long time, for example, in some kind of rubble after the collapse of rocks or buildings.

Much less often, but still there is (and therefore this option cannot be ruled out) a completely different picture of damage – without visible strong external influences. For example, during pregnancy, or as a complication accompanying some serious illness.

As a result of all of the above factors, internal hemorrhages occur, which are accompanied by large blood loss and lead to serious consequences.

Symptoms

Liver contusion must be diagnosed as soon as possible, and it is necessary to determine whether there are open wounds, whether there are closed gaps in addition to them. To carry out surgery, while the victim has not yet lost much blood.

For a correct diagnosis, you need to clearly know what are the signs of a rupture of this organ. The symptoms of this traumatic pathology are as follows:

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  • Pain, cramps or lumbago in the peritoneum. Moreover, it hurts less when the patient is sitting. When you try to stand, lie down, or roll over from side to side (usually, from right to left), the sensations increase.
  • Hematoma of the liver manifests itself in the same way as other bleeding, both external and internal, – the skin turns white, and the lips turn blue.
  • Other symptoms of a bruised liver, leading to rupture, are such – nausea, vomiting, against the background of a strongly tense and drawn inward abdomen.
  • Hands and feet get cold, the whole body becomes covered with cold sweat, the patient experiences a serious pain shock, loses consciousness.
  • Dry mouth, great desire to drink.
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Classification

Liver injury of this kind can be divided into several types, or rather degrees. The degree of organ damage, what is it? This is how severe the injury to the liver is, how much the bleeding is, and what kind of threat it poses to a person’s life.

Degrees (according to ICD-10):

  • I – a small (no more than one centimeter in total) hematoma of the liver, with possible subcapsular hemorrhages without breaking the capsule,
  • II – no longer bruises, but more serious full-fledged ruptures, one to three centimeters long (or depth), severe hemorrhage that goes inside the organ. In this case, a more real threat to the patient’s life arises, which is complicated by untimely diagnosis,
  • III – about half and less than one of the lobes of the gland is ruptured,
  • IV – more than ½ of one of the lobes of the liver is injured, a rupture of one of the leading blood vessels of the organ is possible, profuse bleeding into the abdominal cavity. A very serious threat to human life, urgent hospitalization is required for the operation
  • V – up to 90% of the entire interior is subject to rupture, rapid outflow of blood into the peritoneum, the probability of a positive outcome is minimal.

Diagnostics

Liver hematoma is diagnosed in several ways. This is done in order to get as complete a picture as possible of how severe the liver damage has occurred as a result of the stroke.

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First of all, doctors assess the general condition of the victim, find out what caused the organ injury. If the patient is conscious and able to answer questions, this greatly facilitates the task.

An injured person delivered to the hospital is prescribed an urgent ultrasound scan, a laparoscopic examination of the abdominal cavity is performed to assess the degree of liver damage. Also, a blood test for the content of erythrocytes helps in diagnosis.

The lower this indicator, the stronger and more intense the internal bleeding. It is worth noting that this analysis is done several times in order to evaluate the result in dynamics and to note the improvement or deterioration of the patient’s condition. In addition, a blood test for erythrocytes will show, after the intervention, if suddenly there are ruptures that the surgeons did not notice during the operation.

Treatment

Hematoma of the liver, regardless of the severity, is treated in a hospital setting, treatment at home is by no means acceptable. Treatment of organ injuries must be started without delay, often not only the state of health, but also the patient’s future life depends on it.

First, as already mentioned earlier, there is an operational comprehensive diagnosis of the damage received during the impact. Further, the treatment of the bruise should be limited to stopping the bleeding and restoring the hemostasis of the whole organism as a whole.

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For this, surgeons look for a place of bruising, suture all breaks, treat wounds. After that, if necessary (if not a minimally invasive, but a full-fledged abdominal operation was performed or the anterior abdominal wall was damaged), the muscles and skin are sutured.

Also, during the process, blood and other liquid accumulated in the abdominal cavity are pumped out. If necessary, a drain is placed in the peritoneum to further remove fluid.

The patient is prescribed complete rest, bed rest. Anti-inflammatory drugs, vitamins are also prescribed to support the general condition of the body and help it cope with trauma as soon as possible.

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In addition, the patient is prescribed a special gentle diet. The first time after the operation, except for water, nothing is allowed. After a while, they are allowed to feed the injured person with broths and liquid mashed cereals.

As the patient recovers, more food is allowed. However, some restrictions will have to be observed for a fairly long period.

In order not to burden the liver, which has received a serious blow (in the direct and figurative sense), it is worth removing foods that are heavy for the organ from the diet. That is, alcohol, fat content, smoked meats, salinity, sweets should be strictly prohibited.

Forecast

Liver rupture is a rather complex traumatological pathology. Often it occurs “not alone”, but is accompanied by injuries, bruises, punctures, ruptures of other viscera. The consequences of what happened can be completely different, and depend on many factors.

First of all, it depends on how severe the injury is, how badly the organ is torn or damaged, as well as on how promptly and timely the victim was provided with adequate assistance.

If doctors intervened quickly, it prevents the situation from getting worse. I must say that with timely assistance, forecasts can be quite favorable even with the fourth degree of organ damage.

And, on the contrary, a person is in serious danger even with minor hematomas, but not diagnosed correctly. In this case, without proper treatment, even with a simple pathology, a person can die from internal hemorrhage.

VIDEO

Why the blow to the liver is so painful and crushing.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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