Injury pattern, outcomes and management of liver trauma

Aims and Objectives: To determine the major injury patterns, outcomes and management options of liver trauma in a tertiary care setup in Karachi, Pakistan. Materials and Methods: A prospective clinical study that was carried out consisted of 61 patients with liver trauma, 58 males and 3 female, with the mean age 31.46 years. Data regarding age, sex, mode and type of injuries were taken and analyzed. Inclusion criteria included age group equals or more than 13 years of age with diagnosis of liver trauma, patients penetrating and non-penetrating traumatic injury to liver, patients with blunt and sharp injury to liver. Exclusion criteria included all the patients’ less than 13 years of age, patients with pre-existing liver disease i.e. cirrhosis, tumors, hepatitis etc, Patients who have previously undergone hepatic surgery. This study was conducted during the time period of 1st January 2010 till 31st December 2011. The data was analyzed using SPSS 17. Results: The incidence of liver trauma due to non-penetrating injuries was 47(77%) while due to penetrating injuries 14 (23.0%), with a value of p= 0.001. In all cases of blunt injuries, 67.2% patients were presented due to road traffic accidents, and 9.8% patients were due to assaults. In all cases of liver trauma, 08 patients (13%) sustained Grade I liver injury, 27 patients (44.3%) had Grade II liver injury, 20 patients (32.8%) of Grade III liver injuries, 04 (6.6%) patients of Grade IV and 02(3.3%) of Grade V liver injury. 17(27.9%) patients were hemodynamically stable, and managed Medically with strict vital monitoring, input/output charting and repeated examinations. 44(72%) patients were hemodynamically unstable despite aggressive resuscitation and were managed surgically. Conclusion: Non-penetrating liver injuries are most common (77.0%) in our population especially due to road traffic accidents (67.0%). Surgical management has a provital role in saving life where the patient is hemodynamically unstable.