Spectrum of liver injuries in abdominal trauma

ABSTRACT

A study of 42 cases of hepatic trauma over a period of three years is presented. Spectrum of liver injuries resulting both from blunt and penetrating trauma were analysed. Total of 88% [n=37] patients underwent exploratory laparotomy and 12%[n=5] patients were treated conservatively. 62% [n=26] patients had multiple associated injures whereas 38% [n=16] had isolated liver injury. On presentation 28.5% [n=12] patients had hypotension, systolic blood pressure< 80mm of Hg whereas 71.4% [n=30] were haemodynamically stable. It has been observed that majority of liver injuries do not require aggressive surgical treatment. Thirty three patients [78%] fell in grade I-III and 9 [12%] were in grade IV-V. A significant proportion of these patients could have been managed conservatively only if ICU, serial ultrasound and CT scan facilities were available. A high incidence of morbidity and mortality is noted in patients with multiple injuries. Effectiveness of different treatment modalities is discussed