Tratamento não-operatório do trauma hepático

Nonoperative management of blunt hepatic trauma

ARTIGO DE ATUALIZAÇÃO

Tratamento não-operatório do trauma hepático

Nonoperative management of blunt hepatic trauma

Samir Rasslan, TCBC-SP; Ricardo Portieri Monteiro, ACBC-SP

Professor Titular da Disciplina de Cirurgia de Emergência. 2. Pós-Graduando Assistente do Serviço de Emergência

^{Endereço para correspondência}

RESUMO

O fígado é o órgão mais comumente lesado nos traumatismos abdominais; no entanto, com freqüência a laparotomia revela ausência de sangramento ativo, limitando-se a intervenção à limpeza e drenagem da cavidade. Em função deste aspecto e do fato de que a maioria das lesões hepáticas é de menor gravidade, surgiu a opção do tratamento não-operatório. Esta conduta representa hoje a terapêutica de escolha nas lesões hepáticas em doentes conscientes e estáveis do ponto de vista circulatório. A experiência mostra que é um método seguro, efetivo e com excelentes resultados. Neste artigo, os autores fazem uma revisão e análise crítica do assunto, discutindo os critérios de seleção dos doentes, a avaliação e os riscos e complicações do tratamento não-operatório do trauma hepático.

Unitermos: Trauma hepático; Fígado; Traumatismos abdominais; Tratamento não-operatório.

ABSTRACT

The liver is the most common organ damaged in abdominal trauma. Frequently, the cellotomy reveals a minor hepatic lesion with no signs of active bleeding. And the surgeon quite often finish the procedure with simply cleaning and drainage of the abdominal cavity. Due to the above mentioned aspects, the nonoperative management appears to be a reasonable option. Actually, such initial approach represents the treatment of choice in victims of blunt trauma with hepatic injuries that reach the hospital with normal levell of conscience and hemodynamic stability. Authors in this article, make a review and discuss the pattern selection's criteria, morbidity and mortality of the nonoperative management of blunt hepatic trauma.

Key words: Nonoperative management; Hepatic trauma.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Recebido em 3/11/99

Aceito para publicação em 5/11/99

Trabalho realizado no Serviço de Emergência do Departamento de Cirurgia da Faculdade de Ciências Médicas da Santa Casa de São Paulo.

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Endereço para correspondência:

Dr. Samir Rasslan

Rua Marquês de Itu, 837 / sala 13

01223-001 - São Paulo-SP

Datas de Publicação

• Publicação nesta coleção
  24 Nov 2009
• Data do Fascículo
  Dez 1999

Histórico

• Aceito
  05 Nov 1999
• Recebido
  03 Nov 1999