Management of Abdominal Trauma with Liver Injuries among Patients in Riyadh, Saudi Arabia

Abstract

Background: recently, there was a shift in the management plan for liver blunt trauma from operative to non-operative treatment, as there were advances in critical care and sensitivity of diagnostic tools for detection of liver injury such as CT scan. Objectives: To estimate the prevalence and correlates of non-operative management of liver injury among abdominal trauma patients admitted under surgical team care. Patients and Methods: this is a retrospective cohort study carried out in Riyadh, Saudi Arabia from May 2017 to June 2018. All patients admitted to general surgery departments with abdominal trauma and liver injuries were included. Variables were obtained through file review. Results: the study included 54 patients with liver trauma. Their age ranged from 7 to 60 years with mean age of 29.2±11.3. Male was the dominant gender; with male to female ratio were 8 to 1. Regarding mechanism of injury, all cases of fall down and 88.9% of road traffic accidents compared to none of penetrating injury were treated non-operatively, p=0.011. Concerning CT grading, all cases of grade I compared to 75% of grade IV and 70% of grade III were treated non-operatively, p=0.016. Majority of patients treated non-operatively (45/48; 93.8%) compared to one third of those treated operatively (2/6; 33.3%) were improved on discharge, pConclusion: the prevalence of non-operative management of liver injury in Riyadh hospitals is currently very high, ever for high-grade injuries. Most of them were improved on discharge compared to those managed operatively.