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Blunt hepatic injury.

A Alho, O Karaharju, E Kallio

    Annales Chirurgiae Et Gynaecologiae
    |January 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

    Blunt hepatic injuries in trauma patients often require surgical intervention, with suturing being the preferred method for managing liver lacerations. Immediate re-operation is crucial for achieving hemostasis in unstable patients, despite high mortality rates.

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    Area of Science:

    • Trauma Surgery
    • Hepatobiliary Surgery
    • Emergency Medicine

    Background:

    • Blunt hepatic injuries are a significant concern in patients with multiple traumas.
    • Hemorrhage from liver injuries frequently co-occurs with bleeding from other sites, complicating patient management.

    Purpose of the Study:

    • To evaluate the management strategies and outcomes of blunt hepatic injuries in patients undergoing laparotomy.
    • To identify factors influencing mortality in blunt liver trauma.

    Main Methods:

    • Retrospective analysis of 56 cases of blunt hepatic injuries within 255 laparotomies for multiple traumas.
    • Review of pre-operative shock status, diagnostic methods (laparocentesis, peritoneal lavage), surgical interventions (suturing, local/lobar resection), and post-operative management.

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  • Assessment of mortality rates associated with hepatic injury and multiple traumas.

    • Main Results:

    • One-half of patients presented in profound shock; hepatic bleeding often accompanied injuries to the spleen or retroperitoneum.
    • Suturing was performed in 43 cases, local resection in 10, and lobar resection in 3.
    • Manual compression was effective for temporary hemostasis; immediate re-operation improved outcomes in unstable patients.
    • Mortality was 17% for multiple blunt injuries and 41% for those with hepatic injury.

    Conclusions:

    • Blunt liver trauma can frequently be managed with suturing, with hepatic resection being rarely necessary.
    • Prompt surgical intervention and re-operation for hemostasis are critical in managing severe blunt hepatic injuries.
    • Hepatic injuries significantly increase mortality in patients with multiple traumas.