RUPTUR HEPAR

• Liver merupakan organ solid yang mudah cedera pada kasus trauma abdomen. • Disebabkan ukuran yang besar, posisi yang terfiksasi, dan konsistensi

yang rapuh• Suplai perdarahan yang kaya menuju liver menyebabkan mudah

terjadi perdarahan hebat saat terjadi cedera.• Pengetahuan tentang segmentasi liver amat penting untuk

menenetukan pembedahan (segmentectomy, lobectomy)

• Friable parenchyma, thin capsule, fixed position in relation to spine.• Right lobe gets hit more since its larger, and closer to ribs.• 85% injuries involve segments 6,7,8 from compressioin against ribs,

spine, abd wall.• Shear forces at attachments to diaphragm• Transmission thru right hemithorax

• Liver injured easily in children since ribs are compliant, force transmitted.• Liver not as developed in children, with weaker connective tissue

framework.• Iatrogenic injuries by biopsies, biliary drainage, TIPS, can cause

capsular tears and bile leaks, fistulas, hemoperitoneum