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Hepatic trauma: a 21-year experience.

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    Liver trauma is more common in young males, with penetrating injuries decreasing. Nonoperative management (NOM) is safe and effective for liver trauma, though morbidity remains high, especially in blunt and complex injuries.

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    Area of Science:

    • Trauma Surgery
    • Surgical Outcomes
    • Epidemiology of Injury

    Background:

    • Liver trauma presents significant challenges in patient management.
    • Understanding epidemiological trends and treatment outcomes is crucial for improving care.

    Purpose of the Study:

    • To analyze epidemiological factors, injury patterns, and treatment outcomes of liver trauma.
    • To evaluate the safety and efficacy of nonoperative management (NOM) versus surgical interventions.

    Main Methods:

    • Retrospective analysis of 748 patients aged over 13 admitted between 1990-2010.
    • Inclusion of patients managed surgically or via nonoperative management (NOM).
    • Classification of injuries using the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS).

    Main Results:

    • Penetrating trauma (61.6%) was more common than blunt trauma (38.4%).
    • Blunt trauma predominantly involved lower-grade injuries (I-II), while penetrating trauma often presented with higher-grade injuries (III).
    • NOM was utilized in 25.7% of blunt trauma cases; suturing was the most frequent surgical procedure (41.2%). Liver-related morbidity was 16.7%, with survival rates of 73.5% for blunt and 84.2% for penetrating trauma.

    Conclusions:

    • Liver trauma predominantly affects younger males, with a noted decrease in penetrating injuries.
    • Nonoperative management (NOM) is a safe and effective strategy, increasingly applied to penetrating liver trauma.
    • High morbidity rates persist, with increased mortality observed in blunt and complex liver injuries.