Hepatic injuries: management and outcome

A total of 52 patients with different grades of liver injuries were treated in a 1 year period: 32 patients had penetrating injuries and in 20 patients injuries resulted from blunt trauma. Blunt trauma victims were frequently associated with chest and head injuries and with skeletal fractures. A 4-fold incidence of associated intra-abdominal injuries was encountered in penetrating trauma victims. Blunt and gunshot victims commonly had severe grades of liver injuries (55% and 83.3%, respectively). Stab wounds caused simpler grades of injuries (86.7%). Suture hepatorraphy was the commonest procedure performed (57.7%).The other procedures applied to treat the injured liver were: selective ligation of the injured blood vessels (15.4%); packing (7.7%); and liver resection (3.8%). Two patients died on the operating table before any remedy was applied. The overall morbidity was 40.4%. The liver related complications constituted 17.3%. The total mortality was 13.5% and the liver related mortality was 9.6%.