title: Evaluating a conservative approach to managing liver injuries in Kashmir, India.
abstract: OBJECTIVE
  There has been a steep rise in incidence of liver injury in the past few years because of increase in incidence of road traffic accidents. The aim of this study was to evaluate the role of non-operative management of liver injury due to blunt abdominal trauma.
  
  
  METHODS
  All patients with liver injury from blunt trauma abdomen were studied between January 2000 and January 2010. A total of 152 patients with liver injury were put on conservative management. Hundred and three (67.77%) patients were males and 49 (32.23%) were females with an age range of 15-60 years (32.8 years). Most of the injuries were because of road traffic accidents (81.57%). Liver injuries were graded according to Moore's classification using computed tomography. Patients with Grade V and VI were excluded from the study. Patients who were unstable hemodynamically on admission were also excluded from the study.
  
  
  RESULTS
  There was no mortality in our series. Eight patients needed exploration because they developed hemodynamic instability. Four of the patient developed post-operative liver abscess which was treated conservatively.
  
  
  CONCLUSIONS
  Non-operative management of liver injury due to blunt trauma abdomen is a safe, effective and treatment modality of choice in hemodynamically stable Moore's grade I to Grade IV injury.
authors.affiliation: Department of General Surgery, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar.
authors.forename: Fazl Qadir
authors.initials: FQ
authors.lastname: Parray
authors.forename: Mohd Lateef
authors.initials: ML
authors.lastname: Wani
authors.forename: Ajaz Ahmad
authors.initials: AA
authors.lastname: Malik
authors.forename: Natasha
authors.initials: N
authors.lastname: Thakur
authors.forename: Rouf Ahmad
authors.initials: RA
authors.lastname: Wani
authors.forename: Sameer H
authors.initials: SH
authors.lastname: Naqash
authors.forename: Nisar Ahmad
authors.initials: NA
authors.lastname: Chowdri
authors.forename: Khursheed Alam
authors.initials: KA
authors.lastname: Wani
authors.forename: Akram Hussain
authors.initials: AH
authors.lastname: Bijli
authors.forename: Ifat
authors.initials: I
authors.lastname: Irshad
authors.lastname: Nayeem-Ul-Hassan
references.citation: Acta Chir Orthop Traumatol Cech. 2003;70(4):219-25
references.pmid: 14569858
references.citation: Clin Radiol. 2002 Oct;57(10):908-12
references.pmid: 12413915
references.citation: J Trauma. 1994 Apr;36(4):529-34; discussion 534-5
references.pmid: 8158715
references.citation: Am J Surg. 1995 Apr;169(4):442-54
references.pmid: 7694987
references.citation: J Trauma. 2002 Aug;53(2):238-42; discussion 242-4
references.pmid: 12169928
references.citation: Injury. 2004 Sep;35(9):869-77
references.pmid: 15302239
references.citation: Radiology. 2000 Aug;216(2):418-27
references.pmid: 10924563
references.citation: Arch Surg. 1972 Jun;104(6):781-4
references.pmid: 5029409
references.citation: J Am Coll Surg. 2005 May;200(5):648-69
references.pmid: 15848355
references.citation: Ann Surg. 1992 May;215(5):492-500; discussion 500-2
references.pmid: 1616386
references.citation: J Trauma. 1996 Apr;40(4):607-10; discussion 611-2
references.pmid: 8614041
references.citation: J Trauma. 1995 Aug;39(2):344-50
references.pmid: 7674405
references.citation: Pediatr Radiol. 2000 Aug;30(8):546-50
references.pmid: 10993539
references.citation: J Trauma. 1990 Jan;30(1):44-8
references.pmid: 2296066
references.citation: J Trauma. 1994 Oct;37(4):616-21
references.pmid: 7932893
references.citation: J Trauma. 1996 Jan;40(1):31-8
references.pmid: 8576995
references.citation: Am Surg. 2000 Apr;66(4):332-6
references.pmid: 10776868
references.citation: Langenbecks Arch Surg. 1999 Oct;384(5):453-60
references.pmid: 10552291
references.citation: J Pediatr Surg. 1992 Apr;27(4):466-8
references.pmid: 1522458
references.citation: J Pediatr Surg. 1983 Aug;18(4):512-8
references.pmid: 6620099