Options in treating trauma to the liver

Many wounds of the liver are minor and require no corrective operations. If these patients are not killed by associated injuries, they usually survive. Hemorrhage from hepatic wounds is the most common cause of death. Selective ligation of appropriate blood vessels swiftly controls bleeding and does not cause septic hepatic necrosis because the liver in humans is sterile and collateral blood flow prevents complete infarction of hepatic tissue. Hepatic resection is dangerous in acutely hypovolemic patients, but hepatic resection is beneficial in treating the late complications of hepatic trauma. Liver-related sepsis after trauma to the liver can be obviated by elimination of gauze packs, absorbable hemostats, peritoneal drains, sutures and choledochal tubes.