{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:55:43Z","timestamp":1792043743088,"version":"4.4.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Little is known about the clinical importance of concomitant injuries in polytraumatized patients with high-grade blunt liver injury. A retrospective single-centre study was performed to investigate the safety of non-operative management of liver injury and the impact of concomitant intra- and extra-abdominal injuries on clinical outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Some 183 patients with blunt liver injury were admitted to Berne University Hospital, Switzerland, between January 2000 and December 2006. Grade 3\u20135 injuries were considered to be high grade.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Immediate laparotomy was required by 35 patients (19\u00b71 per cent), owing to extrahepatic intra-abdominal injury (splenic and vascular injuries, perforations) in 21 cases. The mortality rate was 16\u00b79 per cent; 22 of the 31 deaths were due to concomitant lesions. Of 81 patients with high-grade liver injury, 63 (78 per cent) were managed without surgery; liver-related and extra-abdominal complication rates in these patients were 11 and 17 per cent respectively. Grades 4 and 5 liver injury were associated with hepatic-related and extra-abdominal complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Concomitant injuries are a major determinant of outcome in patients with blunt hepatic injury and should be given high priority by trauma surgeons. An algorithm for the management of blunt liver injury is proposed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.6439","type":"journal-article","created":{"date-parts":[[2008,12,24]],"date-time":"2008-12-24T09:44:26Z","timestamp":1230111866000},"page":"104-110","source":"Crossref","is-referenced-by-count":39,"title":["Concomitant injuries are an important determinant of outcome of high-grade blunt hepatic trauma"],"prefix":"10.1093","volume":"96","author":[{"given":"B","family":"Schn\u00fcriger","sequence":"first","affiliation":[{"name":"Department of Visceral and Transplantation Surgery, Berne University Hospital , Berne,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Inderbitzin","sequence":"additional","affiliation":[{"name":"Department of Visceral and Transplantation Surgery, Berne University Hospital , Berne,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Schafer","sequence":"additional","affiliation":[{"name":"Department of Visceral and Transplantation Surgery, Berne University Hospital , Berne,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Kickuth","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic, Interventional and Paediatric Radiology, Berne University Hospital , Berne,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Exadaktylos","sequence":"additional","affiliation":[{"name":"Trauma and Emergency Unit, Berne University Hospital , Berne,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Candinas","sequence":"additional","affiliation":[{"name":"Department of Visceral and Transplantation Surgery, Berne University Hospital , Berne,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2009,1,1]]},"reference":[{"key":"2024093006405525600_bib1","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1002\/bjs.1800791238","article-title":"Liver trauma: a 10-year experience","volume":"79","author":"John","year":"1992","journal-title":"Br J Surg"},{"key":"2024093006405525600_bib2","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1001\/archsurg.138.5.475","article-title":"High success with nonoperative management of blunt hepatic trauma: the liver is a sturdy organ","volume":"138","author":"Velmahos","year":"2003","journal-title":"Arch Surg"},{"key":"2024093006405525600_bib3","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1097\/00000658-199506000-00013","article-title":"Nonoperative management of blunt hepatic trauma is the treatment of choice for hemodynamically stable patients. 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