A Prospective Study on the Management of Liver Trauma

Abstract

BACKGROUND: Assessing the factors responsible for morbidity and mortality of Liver Injury. Evaluating the operative and non-operative options of management of Liver injury and to study the postoperative complications and management of Liver injury. MATERIAL AND METHODS: This prospective study of 50 patients was done from June 2012 to October 2014 (24 months) with aim of presenting the incidence of liver injury and grade of liver injury. RESULTS: The incidence of Liver Trauma is 22.3% in our study. The most common age group involved in the injury are younger age group (21-40 years).Male is involved more in liver injury. Duration between incidence of injury and admission is highly significant. Patients who presented within 2 hours of injury, experienced minimal complications. The lapse time from injury to surgery is highly significant (P<0.019). Survival rate of patients who were operated within 12 hours of injury was 69% higher than the patients who were operated after 12hours of injury. Associated injuries were present in less than 50% of the patients and 10% of patients (9/50) expired of associated injuries still the diagnostic tool for evaluating liver injury. Right lobe is the commonly injured lobe and Grade I and Grade II Liver injuries are the common injuries presented with (56%). (P<O. 00025). Patients with Grade V and Grade VI Liver injuries had 50% mortality. In stable patients kept on conservative management.1 patient developed biliary leak, 2 developed liver abscesses and the other affected with atelectasis. Preferred surgical technique for inaccessible bleeding within a laceration is rapid finger fracture hepatotomy and direct suture or ligation. Hemorrhage due to primary trauma and secondary to sepsis are having poor prognosis. CONCLUSIONS: high mortality could be that 54% of our sample is hemodynamically unstable at presentation, high incidence of complications in patients who were operated and also delayed presentation to hospital leading to poor prognosis.