The timing of histologic changes in liver lacerations

Microscopic examination was performed on 55 cases of traumatic liver lacerations incurred from fatal motor vehicle accidents. None of the deaths was due to the liver injury. In 38 of 55 cases, the decedent was pronounced dead at the scene. Microscopic examination of the liver lacerations in these 38 cases revealed no histologic changes related to the trauma. In 17 of 55 cases, the decedent was transported to the emergency room (ER) with a "survival time" (from Emergency Medical Service arrival to the time of pronouncement) of 15 minutes to 7 hours and 10 minutes. Nine of these 17 had vital signs at the scene. Five of the 17 had neutrophilic infiltration and hepatocyte necrosis at the site of the laceration. Four of these had vitals signs at the scene. Survival time of the 5 patients with a vital reaction at their liver injury ranged from 51 minutes to 7 hours and 10 minutes.