[The surgery of liver trauma (clinical contribution)]

Authors perform a retrospective review of all hepatic injuries operated on between 1974 and 1990 at Clinica Chirurgica II (ex Patologia Chirurgica II, ex Semeiotica Chirurgica) of Policlinico San Matteo (IRCCS) of Pavia. Thirteen patients were treated, 9 men and 4 women, with age ranged from 13 to 68 years and a mean age of 38 years. They were 21% of all patients operated on for abdominal trauma. Penetrating wounds were present in only two cases (15%), the other patients (85%) were affected by blunt trauma. The mechanisms of injuries were: road accidents (77%), fall at work (8%), gun shot wound (8%), stab wound (8%). All patients had associated injuries. The mortality was 31%: one patient died for haemorrhagic shock and the other three for craniocerebral injuries. After reviewing the several haemostatic techniques advocated for the various types of hepatic injuries, the authors stress that, although most lesions are minor and can be managed by simple technique of haemostasis, often the prognosis is severe for the associated injuries.