Hepatic trauma: experience of 110 cases

A total of 110 patients with hepatic injuries was treated at a major urban trauma centre between June 1988 and December 1991. The mechanism of injury was blunt trauma in 86 patients (78 per cent). Non-operative treatment was given in six patients (5 per cent). Simple hepatorrhaphy, use of topical haemostatic agents or peritoneal drainage alone were performed in 79 (72 per cent) cases. Extensive hepatorrhaphy, hepatotomy with selective vascular ligation, resection and débridement or resection, perihepatic packing and major vascular ligation were undertaken, often in combination, in 25 (23 per cent) cases. Percutaneous arterial embolization was carried out in one case. The mortality rate was 18 per cent. The most frequent postoperative complications related to hepatic injury were intra-abdominal abscess (7 per cent) and coagulopathy (5 per cent); prolonged biliary leak (3 per cent), late haemorrhage (2 per cent) and hepatic necrosis (1 per cent) were also observed.