[Problems in the management of liver trauma (author's transl)]

In the last ten years 43 patients with blunt liver trauma and 11 with penetrating liver wounds have been treated. The mortality rate after blunt liver trauma was close to 63%; all penetrating wounds were survived. The prognosis after trauma depended significantly on the number of additional wounds, the extent of blood loss, and the age of the patients. Management of liver trauma was performed in most of the cases (n = 41) by suture and drainage. Packing of the wounds and resection were performed in four cases each. In nine cases, the bleeding did not stop sufficiently after suture, debridement, or packing of the wounds. It is concluded that in those cases hepatic resection or hepatic artery ligation - depending on the extent of trauma - should be done in future.