Evaluation of the healing time of non-operatively managed liver injuries.
OBJECTIVE
Post discharge prescriptions and follow-up protocols after non-operative treatment of blunt liver injuries are still controversial. The aim of this study was to detail the evolution of the hepatic injuries considering their different patterns and severity grades, stated by the Liver Injury Scale.


METHODS
Analysis of a database concerning 79 consecutive patients submitted to ultrasound follow-up until complete recovery of liver injury.


RESULTS
All patients had an uncomplicated course and the liver restoration was demonstrated between 3 and 300 days after the trauma. The median healing time of hematomas increased with the grading (p<0.001): 6 days (IQR=6.75), 45.5 days (IQR=91) and 108 days (IQR=89) for I, II and III grade lesions, respectively. Similarly behaved the lacerations and 29 days (IQR=14.25), 34 days (IQR=43.5) and 77.5 days (IQR=83.5) was the median healing time of II, III and IV grade lesions, statistical significance emerging only comparing II to IV grade lacerations (p<0.035). Considering the different lesion patterns within the same severity grade, the liver restoration was more prompt after lacerations (p<0.001).


CONCLUSIONS
These data suggest that medical prescriptions and follow-up protocols can be tailored considering the lesion characteristics.
Tiberio
Guido Alberto Massimo
GA
Surgical Clinic, Department of Medical and Surgical Sciences, Brescia University, Brescia, Italy. guido.tiberio@libero.it
Portolani
Nazario
N
Coniglio
Arianna
A
Piardi
Tullio
T
Dester
Sara Elisabetta
SE
Cerea
Katia
K
Parrinello
Giovanni
G
Giulini
Stefano Maria
SM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000145:classification / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D007362:Intensive Care Units; D022125:Lacerations / Q000145:classification / Q000000981:diagnostic imaging / Q000628:therapy; D007902:Length of Stay; D008099:Liver / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography; D014945:Wound Healing / Q000502:physiology*; D014949:Wounds, Nonpenetrating / Q000145:classification / Q000000981:diagnostic imaging* / Q000628:therapy