Hepatic trauma management and outcome; Our experience

Abstract

Injuries to the liver have been reported in 35-45% of patients with significant blunt abdominal trauma. Since the introduction of ultrasonography and computerized tomography in the evaluation of these patients, there has been an increase in number of hepatic injuries diagnosed that previously would not have been apparent. The purpose of this study was to determine the epidemiology and pattern of isolated liver injury, significant factors related to management and outcome. A retrospective study of 50 cases of isolated Hepatic trauma admitted and managed over span of last three years (June 2006-June 2009) at MGM Medical College, Navi Mumbai. Out of 50 Patients of isolated liver injury, 36 (72%) were managed conservatively. 14(28%) Patients with refractory hypotension and hemoperitoneum were operated in emergency. The mortality of 3 (6%) cases was related to massive bleeding from liver parenchyma. The line of management of isolated liver trauma is primarily guided by the haemodynamic status of the patient at the time of presentation in emergency department and findings on ultrasonography [FAST] and computerized tomography. There is significant association of line of management with volume of hemoperitoneum and number of blood transfusion.