Management of the traumatized liver: an appraisal of 63 cases.
A review of all patients with liver trauma admitted to the Royal Adelaide Hospital during the period 1983-86 was undertaken. Twelve of the 63 patients died. Liver trauma was responsible in eight (giving a mortality rate of 12.7%). The overall mortality rate was 19.0%. Most of the liver injuries (83%) were due to blunt trauma. All the deaths occurred in this group and were related directly or indirectly to blood loss. A high mortality (83%) was associated with hepatic vein injury. Right hepatectomy was unsuccessful in preventing death in any of these patients. The management of major venous injuries is discussed. A significant number of the liver injuries was minor. Analysis of these suggests that a more conservative approach to the management of haemodynamically stable patients might be appropriate.
Watson
D I
DI
Hepatobiliary and Pancreatic Unit, Royal Adelaide Hospital, South Australia.
Williams
J A
JA
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D003131:Combined Modality Therapy; D005069:Evaluation Studies as Topic; D005260:Female; D006498:Hepatectomy; D006503:Hepatic Veins / Q000293:injuries / Q000601:surgery; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage; D011183:Postoperative Complications / Q000209:etiology; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*