ABSTRACT
Objective To study the effective method of improving the diagnosis and treatment of blunt liver injury.Methods The clinical data of 135 cases with blunt liver injury hospitalized in Daxing District People' s Hospital from January 2000 to October 2010 were reviewed retrospectively.Results By standard grading of American Society of Trauma Surgery (AAST) in 1994,36 cases were grade Ⅰ,42 cases gradeⅡ,33 cases gradeⅢ,14 cases grade Ⅳ,10 cases gradeⅤ.Fifty-one cases were treated by non-operative therapy,among which 42 cases were crued,9 cases underwent operative surgery.Ninety-three cases were treated by operative therapy,seven cases died.The morbidity related to blunt liver injury was 5.19％.Conclusions Non-operative therapy may be used firstly in patients with stable hemodynamics,but close monitoring should be done for changes of the life signs.Timely and reasonable choice of time and the way of surgery is important to avoid complications and reduce the mortality rate.
ABSTRACT
A clinical review was done in 31 children with blunt liver injury admitted to the Department of Surgery, Kyungpook National University hospital between 1981 and 1990. 17 of the 31 children with injured liver required laparotomy. (11 hepatorrhaphy, 4 lobectomy, 2 segmentectomy) There were two deaths after laparotomy, one from associated severe head injury and one from multi organ failure and the remaining 14 children, who were hemodynamically stable after initial resuscitation and without signs of other associated intraabdominal injuries, were managed by nonoperative treatment. Patients were observed in a pediatric intensive care unit for at least 48 hours with repeated abdominal physical examination, laboratory studies, vital sign check and bed rest. The hospital courses in all cases were uneventful and there were no late complication. A follow-up computed tomography was obtained in 7 patients, showing resolution of the injury in all. The authors believe that, for children with blunt liver injuries, nonoperative management is safe and appropriate if carried out under careful continuous surgical observation in a pediatric intensive care unit.