Is computed tomography necessary to determine liver injury in pediatric trauma patients with negative ultrasonography?

Kaya, U. | Cavus, U. Y. | Karakilic, M. E. | Erdem, A. B. | Aydin, K. | Isik, B. | Abacioglu, Serkan

Article | 2013 | EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY39 ( 6 ) , pp.641 - 646

Purpose Abdominal trauma is the third most common cause of all trauma-related deaths in children. Liver injury is the second most common, but the most fatal injury associated with abdomen trauma. Because the liver enzymes have high sensitivity and specificity, the use of tomography has been discussed for accurate diagnosis of liver injury. Methods Our study was based on retrospective analyses of hemodynamically stabil patients under the age of 18 who were admitted to the emergency department with blunt abdominal trauma. Results Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were significantly higher as a . . .result of liver injury. In the patients whose AST and ALT levels were lower than 40 IU/L, no liver injury was observed in the contrast-enhanced computed tomography (CT). No liver injury was detected in the patients with AST levels lower than 100 IU/L. Liver injury was detected with contrast-enhanced CT in only one patient whose ALT level was lower than 100 IU/L, but ultrasonography initially detected liver injury in this patient. Conclusions According to our findings, abdominal CT may not be necessary to detect liver injury if the patient has ALT and AST levels below 100 IU/L with a negative abdominal USG at admission and during follow-up Daha fazlası Daha az

Effect of oophorectomy and exogenous estrogen replacement on liver injury in experimental obstructive jaundice

Uçan H.B. | Kaplan M. | Salman B. | Yilmaz U. | Menteş B.B. | Aybay C.

Article | 2008 | World Journal of Gastroenterology14 ( 18 ) , pp.2818 - 2824

Aim: To investigate the role of estrogen on liver injury in an experimental obstructive jaundice model. Methods: Three groups of female rats were constituted; group 1 was oophorectomized and given E2 (n 14), group 2 was oophorectomized and given placebo (n 14), and group 3 was sham operated (n = 14). Fourteen days following constitution of bile duct ligation, all groups were compared in terms of serum tests, histopathologic parameters, and tissue levels of IFN-? and IL-6. Results: The parameters representing both the injury and/or the reactive response and healing were more pronounced in groups 1 and 2 (? 2 = 17.2, ?2 = 10.20; ?2 = . . .12.4, P < 0.05). In the sham operated or E2 administered groups significantly lower tissue levels of IFN-? and higher IL-6 levels Were found. In contrast, high IFN-? and low IL-6 tissue levels were found in the oophorectomized and placebo group (P < 0.001). Kupffer cell alterations were observed to be more pronounced in the groups 1 and 3 (?2 = 6.13, P < 0.05). Conclusion: Our study indicates that E2 impaired liver functions, accelerated both the liver damage and healing. In the conditions of bile duct obstruction, estrogen significantly changed the cytokine milieu in the liver. © 2008 WJG. All rights reserved Daha fazlası Daha az

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