title: Blunt hepatic trauma: comparison between surgical and nonoperative treatment.
abstract: OBJECTIVE
  To examine the outcomes of blunt hepatic trauma, and compare surgical and non-surgical treatment in patients admitted with hemodynamic stability and with no obvious indications of laparotomy.
  
  
  METHODS
  This is a retrospective study of cases admitted to a university teaching hospital between the years 2000 and 2010. Patients undergoing surgical treatment were divided into two groups: (a) all patients undergoing surgical treatment, and (b) patients with obvious need for surgery.
  
  
  RESULTS
  In this period, 120 patients were admitted with blunt hepatic trauma. Sixty five patients (54.1%) were treated non-operatively and fifty five patients were operated upon. Patients treated non-operatively had better physiologic conditions on admission, demonstrated less severe injuries (except the grade of hepatic injury), received less blood components and had lower morbidity and mortality than the patients operated upon. Patients who underwent non-operative treatment had a lower need for blood transfusion but higher rates of complications and mortality than the patients operated upon. Patients who were operated upon, with no obvious indications for surgery, had higher rates of complication and mortality than patients not operated upon.
  
  
  CONCLUSIONS
  A non-operative approach resulted in lower complications, a lower need for blood transfusions and lower mortality.
authors.affiliation: FCM, Unicamp. thiagomzago@hotmail.com
authors.forename: Thiago Messias
authors.initials: TM
authors.lastname: Zago
authors.forename: Bruno Monteiro
authors.initials: BM
authors.lastname: Pereira
authors.forename: Thiago Rodrigues Araujo
authors.initials: TR
authors.lastname: Calderan
authors.forename: Elcio Shiyoiti
authors.initials: ES
authors.lastname: Hirano
authors.forename: Sandro
authors.initials: S
authors.lastname: Rizoli
authors.forename: Gustavo Pereira
authors.initials: GP
authors.lastname: Fraga
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008099:Liver / Q000293:injuries* / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000601:surgery / Q000628:therapy*