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Morphologic changes of the liver following partial hepatic section and omentoplasty

Hepatic trauma is a frequent challenge in emergency services. Most of cases may be treated conservatively, but in presence of major injuries the surgeon need experience to perform the best procedure. One of the most useful approaches to control a severe bleeding caused by an hepatic trauma is the omentoplasty. Despite the good results of this procedure in controlling the haemorrhage, its effects on liver architecture are not well known. In order to verify the influence of omentoplasty on experimental liver trauma we carried out the present experimental investigation. We studied ten rats submitted to a three- centimetre-section of the right liver lobe, 2.5cm from its edge. A segment of the greater omentum was introduced into the liver wound and suture with 5-0 catgut thread. The animals were followed during seven (n=5) or 2/ (n=5) days. Macro and microscopic assessments were done at the end of these periods. All rats supported the operation and survived during the experimental time. The main findings on the seventh day were adhesions of omentum, stomach and colon to the liver. Necrosis and abscesses were found into the distal part of liver section. On the twenty-first day the adhesions to the liver were stronger and the distal liver became fibrotic. In conclusion, omentoplasty is helpful to control life threatening bleeding of the liver but, in the rat, the distal part of a deep wound loses its hepatic characteristics, becoming fibrotic after local sceptic changes.

Liver; Hepatic trauma; Omentoplasty; Macroscopy; Microscopy


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