Conservative management of hepatic trauma

In this study, the conservative management of 54 patients [37 males and 17 females with a mean age of 28 + 12.6 years] with liver trauma [40 cases of blunt trauma and 14 cases of penetrating injury] in the last six years was reviewed. Guided by clinical signs and CT scan, 28 patients were successfully managed without operation [22 with blunt injury and six with penetrating injury]. Most of the operatively managed patients after the failure of the conservative treatment were of grade IV and V liver injury. The complication rate was lower in the nonoperatively managed patients. Only two patients died in the operative group, but no mortality occurred in the nonoperative one. When surgery was done, the simplest maneuver to control bleeding was followed to reduce the morbidity and mortality rates. The clinical assessment and radiological monitoring may reduce the number of unnecessary laparotomies