title: Presentation and outcome of surgically managed liver trauma: experience at a tertiary care teaching hospital.
abstract: OBJECTIVE
  To document and analyse the presentation and outcome of surgical management of liver trauma.
  
  
  METHODS
  The study was a retrospective review of records of all surgeries carried out at the Department of General Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from January 2003 to December 2010. The study included all adult patients of either gender who presented with liver trauma and underwent operative management. Convenience sampling technique was employed. The study excluded patients who were managed conservatively. The data were collected through a proforma and analysed through SPSS 10.
  
  
  RESULTS
  Out of 113 cases of liver trauma, 91 (80.5%) were males and 22 (19.4%) were females. The mean age was 34.8 +/- 9.7 years. Road traffic accidents were the leading cause (n = 75; 66.3%) of injuries. There were 37 (32.7%) patients with grade I injury; 41 (36.2%) with grade II injury; 29 (25.6%) with grade III injury; and 7 (6.1%) patients with grade IV injury. Besides, 62 (54.8%) patients had associated extra-hepatic injuries. Majority of the patients presented with haemodynamic compromise (n = 97; 85.8%). Perihepatic packing was the commonest operative procedure instituted (n = 43;38%). The in-hospital mortality was 9.7% (n = 11).
  
  
  CONCLUSIONS
  Liver trauma constitutes an important cause of emergency hospitalisation, morbidity and in-hospital mortality in our population. It predominantly affects the younger males and road traffic accidents are the leading cause. Majority of the patients are successfully managed with perihepatic packing.
authors.affiliation: Department of General Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad. muhammadsaaiq5@gmail.com
authors.forename: Muhammad
authors.initials: M
authors.lastname: Saaiq
authors.lastname: Niaz-ud-Din
authors.forename: Muhammad
authors.initials: M
authors.lastname: Zubair
authors.forename: Syed Aslam
authors.initials: SA
authors.lastname: Shah
mesh_terms: D000328:Adult; D005260:Female; D017052:Hospital Mortality; D006784:Hospitals, Teaching; D006801:Humans; D008099:Liver / Q000293:injuries* / Q000601:surgery*; D008297:Male; D009104:Multiple Trauma; D010154:Pakistan; D062606:Tertiary Care Centers; D015599:Trauma Severity Indices; D016896:Treatment Outcome