LIVER INJURY |
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General Information
DEFINITION--Laceration, contusion or rupture of the liver. A severe liver injury is an emergency!
BODY PARTS INVOLVED
Liver.
Muscles of the abdominal wall.
Peritoneum (membranous covering to the intestines).
Ribs (sometimes) if fractured at the same time the liver is injured.
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SIGNS & SYMPTOMS
Vomiting.
Pain in the abdomen.
Abdominal tenderness.
Pain in the right shoulder or right side of the neck.
Rapid heart rate.
Low blood pressure.
Signs of shock: pale, moist and sweaty skin; anxiety with a feeling of impending doom; shortness of breath and rapid breathing; disorientation; and confusion.
CAUSESDirect blow to the liver, located in the upper abdomen or right side of the chest.
RISK INCREASES WITH
Contact sports.
Recent injury to the right side of the abdomen or flank (side or back between ribs and hip).
Rib fracture.
Any bleeding disorder such as hemophilia.
Any illness that causes enlargement of the liver.
If surgery is necessary, surgical risk increases with smoking, use of mind-altering drugs, muscle relaxants, tranquilizers, sleep inducers, insulin, sedatives, beta-adrenergic blockers or corticosteroids.
HOW TO PREVENTAvoid causes and risk factors when possible.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's treatment.
Hospitalization for intravenous fluids or transfusions to treat shock.
Surgery under general anesthesia to clamp off bleeding blood vessels and repair the injured liver.
DIAGNOSTIC MEASURES
BEFORE SURGERY:
Blood and urine studies;
X-rays of the abdomen and chest.
AFTER SURGERY:
Examination of all removed tissue.
Additional blood studies.
POSSIBLE COMPLICATIONS
AT THE TIME OF INJURY:
Rapid deterioration due to internal bleeding, possibly leading to death.
AFTER SURGERY:
Excessive bleeding.
Infection.
Incisional hernia.
Lung collapse.
Inflammation of the pancreas.
Deep-vein blood clots.
Pneumonia.
PROBABLE OUTCOMEExpect complete healing if no complications occur. Allow about 4 weeks for recovery from surgery.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AID
Cover the victim with a blanket to combat shock.
Carry the injured person to the nearest emergency facility.
Don't give the person water or food. If surgery is necessary, food or water in the stomach makes vomiting while under general anesthesia more dangerous.
Don't give the person pain relievers. They may mask symptoms and hinder diagnosis.
CONTINUING CARENo specific instructions except those under other headings. If surgery is required, your surgeon will supply postoperative instructions.
MEDICATION
Your doctor may prescribe:
Pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need.
Antibiotics to fight infection.
Stool softeners to prevent constipation.
Pneumonia vaccinations.
You may use non-prescription drugs such as acetaminophen for minor pain.
ACTIVITYReturn to work, play and normal activity as soon as possible. This reduces postoperative depression, which is common. Avoid vigorous exercise for 6 weeks after surgery.
DIETNo food or water before surgery. Following surgery, a clear liquid diet will be necessary until the gastrointestinal tract functions again. During recovery, follow a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.
REHABILITATIONRehabilitation exercises must be individualized. Follow your doctor's or surgeon's directions.
CALL YOUR DOCTOR IF
You receive an abdominal injury and the symptoms last longer than a few minutes, or symptoms diminish and recur within hours or days. This may be an emergency!
Any of the following occur after surgery:
You develop signs of infection (headache, muscle aches, dizziness or a general ill feeling and fever).
Pain, swelling, redness, drainage or bleeding increases in the surgical area.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
Symptoms return after recovery.
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