Background: It has been shown that bleeding from injured Liver can
cease spontaneously, in the majority of blunt hepatic trauma. The aim of
the study was to evaluate the criteria of non-operative management for
patients with blunt hepatic injury.
Study design: Thirty five patients with blunt hepatic trauma were selected
for non-operative management from January 2003 to October
2005. All patients were hemodynamically stable and admitted to the Intensive
Care Unit (ICU) for the first 24-72 hours. They were subjected to
resuscitation, close observation. serial Laboratory investigations and
scanning assessment.
Results: Thirty five patients with liver injuries were classified according
to CT findings into grade I in 2 patients (6%), grade II in 11 patients
(31%), grade III in 12 patients (34%) and grade Win 10 patients (29%). CT
scan revealed minor hemoperitonewn in 8 patients (22.8%), moderate hemoperitoneum
in 10 patients (28.6%) and major hemoperitoneum in 10
patients (28.6%). Liver enzymes ALT and AST levels at admission were
significantly correlated to the grade of the hepatic injury. Non-operative
management succeeded in 28 patients (80%) of patients with blunt hepatic
trauma while 3 patients (8.6%) required laparotomy after initial success
of non-operative management Percutaneous guided drainage was required
for 4 patients (11.4%) with localized collection. The mortality rate
was 2.8%. |
