MANAGEMENT OF LIVER INJURIES IN ABDOMINAL TRAUMA

Abstract

Aim & Objectives: (1): to determine the frequency of liver injuries in abdominal trauma. (2): To find out the most affected age group in
abdominal trauma. (3): To describe criteria for conservative and operative management of abdominal injuries. Design: Prospectus Period:
May 2001 to Oct 2002. Setting: Surgical Department of Allied Hospital, Punjab Medical College Faisalabad. Material & Methods: This study
included 100 patients of abdominal trauma (Blunt / penetrating) admitted through emergency. Male to female ratio was 4 to 1 (male: 40,
female: 10). The age ranged from 05-45 years (mean: 19.7 years). Results: Out of the total number of hundred patients, fifty patients had
hepatic trauma. Out of fifty patients, 18(36%) patients had isolated liver injury and 32(64%) patients had associated organ injuries. Twenty
six patients (52%) suffered from blunt abdominal trauma and twenty four patients (48%) penetrating injuries either due to firearm or stab.
Forty two patients (84%) underwent surgery and 8(16%) patients were given conservative trial. Six patients (12%) recovered on conservative
management while two underwent second operation for peritonitis. Grade I & II liver injuries were found to be most common while one case
of Grade V or VI was noted. Conclusion: Blunt trauma due to toad traffic accidents is the commonest mode of abdominal injuries followed
by penetrating injuries. Heamodynamically stable patients presenting within 6 hours can be treated conservatively. Haemodynamically
unstable patients should be immediately operated.