Traumatic liver rupture

Abstract

A series of 120 patients with liver rupture due to blunt trauma is presented. This includes all patients with this type of injury sustained over a 16-year period in Oslo, which has a population of 480,000. Of the 120 patients, 29 were dead on admission; 4 of these bled to death from liver rupture before reaching hospital and the remaining 25 had other injuries as well. Of the 91 patients admitted alive, 27 were not operated upon; 2 of them survived and from the histories, symptoms, and clinical and radiographic findings were thought to have minor liver injuries. The remaining 25 patients died, of whom 16 also had other injuries, while 9 patients succumbed to their ruptured liver only, bleeding to death in the first few hours after admission without being operated upon. Of the 91 patients who were admitted alive, 64 underwent operation with a mortality of 38 per cent. Four major liver resections were undertaken and all these patients survived. This is the treatment of choice in all bursting injuries of the liver and would probably have saved most of the 17 per cent who bled to death during operation or shortly afterwards. An effective plan for the care of the injured patient with liver rupture requires an adequate ambulance service, reorganization of the immediate reception and treatment at hospital, and the application of modern liver surgery. This again calls for centralized treatment of such patients. A series of 120 patients with liver rupture due to blunt trauma is presented. This includes all patients with this type of injury sustained over a 16-year period in Oslo, which has a population of 480,000. Of the 120 patients, 29 were dead on admission; 4 of these bled to death from liver rupture before reaching hospital and the remaining 25 had other injuries as well. Of the 91 patients admitted alive, 27 were not operated upon; 2 of them survived and from the histories, symptoms, and clinical and radiographic findings were thought to have minor liver injuries. The remaining 25 patients died, of whom 16 also had other injuries, while 9 patients succumbed to their ruptured liver only, bleeding to death in the first few hours after admission without being operated upon. Of the 91 patients who were admitted alive, 64 underwent operation with a mortality of 38 per cent. Four major liver resections were undertaken and all these patients survived. This is the treatment of choice in all bursting injuries of the liver and would probably have saved most of the 17 per cent who bled to death during operation or shortly afterwards. An effective plan for the care of the injured patient with liver rupture requires an adequate ambulance service, reorganization of the immediate reception and treatment at hospital, and the application of modern liver surgery. This again calls for centralized treatment of such patients.