Grade IV blunt hepatic injury treated conservatively and successfully in a non-trauma centre: a case report

Abstract

Management of blunt hepatic injury changed over the past three decades as a non-operative treatment is nowadays advocated by most in haemodynamically stable patients. We present the case of a young female patient with a high-grade blunt liver injury successfully treated in a non-trauma centre. She developed several complications secondary to the injury like a delayed bleeding, two different bilomas and a reactive pleural effusion requiring surgical expertise, interventional radiology, upper gastro-intestinal endoscopy and intensive care facilities. In the literature, the mortality and the morbidity rates for grade IV liver injuries respectively reach 16% and 39%. Because of potential delayed symptoms or signs and high complication rate, we think it should be appropriate to manage such a complex patient in a centre where at least above-mentioned specialities are available. Otherwise, a referral to a trauma centre should be a better option.