Management of hepatic trauma

ABSTRACT

A review of 32 consecutive patients with liver trauma admitted in two surgical units of Mayo Hospital, Lahore in the year 1994 is presented. Majority of patients were young [mean age 26.5 years] male [90.6%]. Penetrating injuries [81%] were far more common than blunt trauma. Firearm injury was later confirmed at laparotomy except in two stable patients where diagnosis was confirmed on ultrasonography. These patients were managed conservatively. Right lobe [59.4%] was primarily involved in trauma. According to Moore's classification of liver trauma, twenty two patients had Grade-1 and II injuries 9 had Grade III and IV and one had Grade V injury. Eighty percent of patients had associated injuries to other organs. Hepatorrhaphy [64.3%] was the commonest amongst the procedures carried out, others were Hepatoomentorrhaphy, [10.7%] resectional debridement with selective ligation of the vessels [14.3%] perihepatic packing [7.1%] and hepatic lobar resection [3.6%]. Morbidity in this series was 59.5% and mortality 12.5%