title: Hepatic trauma: an Indian experience.
abstract: Over a five year period, between January 1989 and December 1993, a total of 230 patients with confirmed hepatic injuries were treated at a major urban trauma center. The mechanism of injury was blunt in 154 patients (67%). Nonoperative treatment was given in 18 patients (8%). All operated patients were explored through a midline incision. A "T" extension over the right hypochondrium was required in 24 patients (10%), while a right thoracotomy extension was needed in 16 patients (7%). Simple hepatorrhaphy, use of topical hemostatic agents or peritoneal drainage alone were performed in 151 (66%) patients. Extensive hepatorrhaphy, hepatotomy with selective vascular ligation, resection with debridement or resection alone, perihepatic packing and major vascular ligation were undertaken, often in combination in 61 (26%) patients. Percutaneous arterial embolization was carried out in one patient. The mortality rate was 19%. The most frequent postoperative complications related to hepatic injury were intraabdominal abscesses (6%) and coagulapathy (5%). Prolonged biliary leak (3%), late hemorrhage (1%) and hepatic necrosis (1%) were also observed.
authors.affiliation: Department of Surgery Lokmanya Tilak Municipal Medical College and General Hospital, Sion Bombay, India.
authors.forename: P
authors.initials: P
authors.lastname: Shah
authors.forename: S
authors.initials: S
authors.lastname: Mohanty
authors.forename: S
authors.initials: S
authors.lastname: Vishweshwar
authors.forename: P
authors.initials: P
authors.lastname: Subramaniyan
authors.forename: V
authors.initials: V
authors.lastname: Dewoolkar
authors.forename: T
authors.initials: T
authors.lastname: Changlani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007194:India; D008099:Liver / Q000293:injuries* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D014949:Wounds, Nonpenetrating / Q000601:surgery; D014950:Wounds, Penetrating / Q000601:surgery