Hepatic trauma and associated injuries- experience in a tertiary care hospital

ABSTRACT

The objective of this study was to analyze and document the presentation of liver trauma and associated injuries. Present study was conducted from January 2010 to December 2011 at Jinnah Postgraduate Center, Karachi, Pakistan. Oral and written consent was obtained from the participants before the start of the study. Inclusion criteria included all patients, aged more than 13 years with hepatic trauma admitted in the wards. The patients with co existing chronic hepatic diseases were excluded. This study comprised of 61 participants, among those [95%] were males and [5%] were females. The mean age of the participants was 31.4. The mean age for female participants was 28.3 while for male was 31.6. Amongst the patients with hepatic trauma, 67.2% had road traffic accidents [RTA] as the cause of their liver injury followed by firearm injury in 19.7%of the cases, physical assault in 9.8% and stab wound in 3.3% of the patients. Investigations done on the patients were ultrasound and C.T scan. In this study 60.7% patients were diagnosed on abdominal ultrasound and 14.8% were found to have hepatic trauma on the abdominal C.T scan. In all the patients with hepatic injury 50.8% had associated injuries. The most common associated injury was chest complications which was present in 10 [16.4%, C.I 3.7-39.7] patients followed by gut perforation which was present in 11.4% patients. Other common injuries included forearm fracture which was present in 09.8%patients, spleen injury was found in 8.1% and diaphragm injury in 4.9% patients. In Pakistan Road traffic accident is one of the most frequent causes of Hepatic injury and middle aged men are at the highest risk of hepatic trauma