<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1405-0099</journal-id>
<journal-title><![CDATA[Cirujano general]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. gen]]></abbrev-journal-title>
<issn>1405-0099</issn>
<publisher>
<publisher-name><![CDATA[Asociación Mexicana de Cirugía General A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1405-00992023000300176</article-id>
<article-id pub-id-type="doi">10.35366/112926</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Manejo conservador de lesión hepática severa por proyectil de arma de fuego]]></article-title>
<article-title xml:lang="en"><![CDATA[Conservative management of severe liver injury by firearm]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gutiérrez-Pérez]]></surname>
<given-names><![CDATA[Jorge Octavio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Grado-Limas]]></surname>
<given-names><![CDATA[Cristina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cabello-Aguilar]]></surname>
<given-names><![CDATA[Yazmín]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cruz-Benítez]]></surname>
<given-names><![CDATA[Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Secretaría de Salud Hospital Regional de Alta Especialidad de Ixtapaluca ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Secretaría de Salud Hospital Regional de Alta Especialidad de Ixtapaluca ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Secretaría de Salud Hospital Regional de Alta Especialidad de Ixtapaluca Servicio de Radiología e Imagen]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Secretaría de Salud Hospital Regional de Alta Especialidad de Ixtapaluca ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2023</year>
</pub-date>
<volume>45</volume>
<numero>3</numero>
<fpage>176</fpage>
<lpage>180</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1405-00992023000300176&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1405-00992023000300176&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1405-00992023000300176&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  el hígado es el órgano sólido intraabdominal más susceptible de lesión por traumatismo abdominal. La falta de evidencia en el tratamiento idóneo de las lesiones de órganos sólidos por proyectil de arma de fuego es problemática cuando el manejo no quirúrgico del trauma hepático es posible. Discutible por la falta de un consenso que resulta apremiante ante la incidencia creciente de lesión hepática severa por proyectil de arma de fuego. La manera cómo manejamos el trauma hepático evoluciona conforme mejora el acceso a recursos como servicios de urgencias equipados, terapia intensiva, laboratorio, disponibilidad continua del personal de salud, cirujanos altamente especializados, tomografía computarizada, quirófano y banco de sangre. Cuando todo está disponible, el manejo no quirúrgico del trauma hepático debe ser el tratamiento estándar en el paciente hemodinámicamente estable, sin irritación peritoneal y sin lesión de otros órganos.  Objetivo:  presentar el caso de una paciente con lesión hepática severa por proyectil de arma de fuego con manejo no quirúrgico exitoso del trauma hepático.  Caso clínico:  paciente con lesión hepática severa por proyectil de arma de fuego fue manejada conservadoramente con éxito.  Conclusiones:  el manejo no quirúrgico de una paciente con lesión hepática severa por proyectil de arma de fuego fue posible en nuestro hospital.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  the liver is the intra-abdominal solid organ most susceptible to injury from abdominal trauma. The lack of evidence on the ideal treatment of solid organ injuries by firearm continues to be a problem when the non-surgical management of hepatic trauma is possible, debatable due to the lack of a consensus that is pressing before the increasing incidence of severe liver injury due to firearm. The way in which we manage liver trauma evolves as accessibility to resources such as equipped emergency services, intensive care, laboratory, continuous availability of health personnel, highly specialized surgeons, computed tomography, operating room and blood bank improves. When this is available, non-surgical management of hepatic trauma should be the standard treatment in hemodynamically stable patients without peritoneal irritation and without injury to other organs.  Objective:  to present the case of a patient with severe liver injury due to gunshot with successful non-surgical management of hepatic trauma.  Clinical case:  a patient with severe liver injury from a gunshot was successfully managed conservatively.  Conclusions:  the non-surgical management of a patient with severe liver injury due to a gunshot was possible in our hospital.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[lesión hepática]]></kwd>
<kwd lng="es"><![CDATA[severa]]></kwd>
<kwd lng="es"><![CDATA[tratamiento conservador]]></kwd>
<kwd lng="en"><![CDATA[liver trauma]]></kwd>
<kwd lng="en"><![CDATA[severe]]></kwd>
<kwd lng="en"><![CDATA[non-operative management]]></kwd>
</kwd-group>
</article-meta>
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