Il ruolo dell’ultrasonografia nel trattamento non operatorio dei traumi epatici

The technical progress in imaging methodology and intensive care over recent years has allowed a reduction in surgical operations for hepatic trauma. In the past, surgeons based their evaluations on clinical findings and patients in critical condition were submitted to surgery. The percentage of negative laparotomies was high (6% to 25%) due to non-haemorrhagic hepatic lesions at surgery. The introduction of ultrasonography and computed tomography offered two important tools for determining the origin and extent of traumatic lesions of the liver and other abdominal organs. These modern imaging techniques enable us to diagnose and monitor patients with hepatic trauma with a reduction in negative laparotomies and allow conservative treatment of numerous traumatic lesions of the liver. Despite the diagnostic superiority of computed tomography in the evaluation of patients with hepatic trauma, the risk of exposure to ionising radiation in several, consecutive examinations in patients undergoing conservative treatment has aroused considerable interest with regard to the use of ultrasonography for both the initial and later evaluation of such patients. We report on our experience with 28 patients with liver traumas, focusing on the role of ultrasonography in their non-operative management.