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COVID-19 is a new disease, based on currently available limited information, older adults and people of any age who have severe underlying medical conditions may be at higher risk for severe illness from COVID-19. People of all age groups are also at risk. Healthcare providers have always been the professionals most exposed to the risk of contracting to any kind of infection due to the nature of their profession. Elective interventions have been postponed to give care of patients with COVID-19. However, some interventions cannot be delayed, such as trauma surgery, acute abdomen, and emergency endoscopies. To maintain the sustainability of the healthcare system, the protection of healthcare providers should be the top priority. On the other hand, patients, who need emergency healthcare, should also be provided with appropriate treatment. Healthcare professionals should choose a treatment method appropriately in the circumstances to protect themselves and their patients as much as possible. This paper aims to summarize how a surgeon may act appropriately when an intervention is inevitable during the COVID-19 pandemic.

Background Liver is the most frequently injured intraabdominal organ following abdominal trauma. Liver injury in polytraumatized patients can vary from minor contusions to major lacerations and is associated with morbidity and mortality. The objective of this study was to evaluate the outcome of liver injury in polytraumatized patients. Methods Only surgically treated 82 patients with liver injury over an eight year period (2005-2013) were included in this study and analyzed retrospectively. Data collected included demographics, laboratory findings, intraoperative findings, operative management, and outcome. The patients were divided into two groups and the mortality and survival data were compared. Results The overall mortality rate was 18.3% (15 of 82 patients). 34 (41.5%) patients had blunt, forty-eight (48.5%) had penetrating trauma. There were multiple traumas in forty-seven (57%) patients. Forty-seven (57%) patients had total of seventy one coexisting intraabdominal injuries. Forty-six (56.1%) patients had stable and thirty-six (43.9%) had unstable hemodynamics on admission. In mortality group AST, ALT, LDH, APTT, PT, INR, and creatinine levels were high, fibrinogen levels and platelet counts were low on admission. Conclusion Hemodynamic instability, coexisting musculoskeletal and chest injury, high APTT, PT, INR, AST, ALT, LDH levels, and low fibrinogen levels and platelet counts on admission should be considered as predictive factors for mortality.