[Liver trauma]

Over a 15-year period 43 patients were treated for liver trauma in a surgical department, subspecialized in liver surgery. The trauma mechanism was blunt in 88% and penetrating in 12%. According to the Organ Injury Scale system of liver trauma, they consisted of 10 in class I, three in class II, 16 in class III, 11 in class IV and three in class V. Thirty-seven patients were treated operatively while six patients were treated conservatively. The overall mortality rate was 9% and liver related mortality 7%. Other organ lesions were present in 53% of the patients. Patients treated conservatively met initial criteria of which the most important was haemodynamic stability. The most important diagnostic method was CT. If strict criteria are followed, a large proportion of liver trauma patients can be treated nonoperatively, provided there is adequate surveillance facilities including CT, and operative capacity to meet unexpected late bleeding complications.