title: Management of traumatic liver injuries.
abstract: Liver injuries in Europe are usually caused by blunt trauma and a high mortality rate is generally reported. The severity of liver injury in 175 patients was graded from I to V and the Injury Severity Score assessed. Seventy-five patients in a prospective study (1987-1990) were treated according to a defined protocol. Non-operative management was used for those who were haemodynamically stable on admission. In unstable patients who proceeded to surgery, liberal use of packing was made and a low threshold for relaparotomy employed. Increasing experience resulted in fewer indications for resection and a 40 per cent rate of non-operative treatment in the prospectively managed group. The overall mortality rate was 12 per cent (15 per cent in the retrospective and 8 per cent in the prospective group). Death in patients with multiple injuries should only rarely result from liver trauma.
authors.affiliation: Department of Visceral and Transplantation Surgery, University of Berne, Inselspital, Switzerland.
authors.forename: W
authors.initials: W
authors.lastname: Schweizer
authors.forename: S
authors.initials: S
authors.lastname: Tanner
authors.forename: H U
authors.initials: HU
authors.lastname: Baer
authors.forename: J
authors.initials: J
authors.lastname: Lerut
authors.forename: A
authors.initials: A
authors.lastname: Huber
authors.forename: P
authors.initials: P
authors.lastname: Gertsch
authors.forename: L H
authors.initials: LH
authors.lastname: Blumgart
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008099:Liver / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D014949:Wounds, Nonpenetrating / Q000401:mortality / Q000601:surgery*