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Hepatic trauma management and outcome; Our experience
Tanweer Karim1, Margaret Topno, Ali Reza
1Department of General Surgery, MGM Medical College, Navi Mumbai, India.
The Indian Journal of Surgery
|November 8, 2012
Summary
Isolated liver trauma management in blunt abdominal injuries is guided by patient hemodynamics and imaging. Conservative treatment is common, but surgery is needed for unstable patients, with outcomes linked to bleeding severity.
Area of Science:
- Trauma Surgery
- Hepatobiliary Surgery
- Emergency Medicine
Background:
- Blunt abdominal trauma frequently causes liver injuries, affecting 35-45% of patients.
- Advanced imaging like ultrasonography and CT scans have increased the diagnosis of hepatic injuries.
Purpose of the Study:
- To investigate the epidemiology and management patterns of isolated liver injuries.
- To identify factors influencing the management and outcomes of liver trauma.
Main Methods:
- Retrospective analysis of 50 isolated hepatic trauma cases from June 2006 to June 2009.
- Review of patient management strategies, including conservative and surgical interventions.
Main Results:
- 72% (36/50) of patients were managed conservatively.
- 28% (14/50) required emergency surgery due to refractory hypotension and hemoperitoneum.
- Mortality (6%, 3/50) was associated with massive liver parenchymal bleeding.
Conclusions:
- Patient hemodynamic status and imaging findings (FAST, CT) dictate management of isolated liver trauma.
- Management decisions are significantly associated with hemoperitoneum volume and blood transfusion requirements.
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