title: Hepatic trauma: a 21-year experience.
abstract: OBJECTIVE
  To evaluate the epidemiological aspects, behavior, morbidity and treatment outcomes for liver trauma.
  
  
  METHODS
  We conducted a retrospective study of patients over 13 years of age admitted to a university hospital from 1990 to 2010, submitted to surgery or nonoperative management (NOM).
  
  
  RESULTS
  748 patients were admitted with liver trauma. The most common mechanism of injury was penetrating trauma (461 cases, 61.6%), blunt trauma occurring in 287 patients (38.4%). According to the degree of liver injury (AAST-OIS) in blunt trauma we predominantly observed Grades I and II and in penetrating trauma, Grade III. NOM was performed in 25.7% of patients with blunt injury. As for surgical procedures, suturing was performed more frequently (41.2%). The liver-related morbidity was 16.7%. The survival rate for patients with liver trauma was 73.5% for blunt and 84.2% for penetrating trauma. Mortality in complex trauma was 45.9%.
  
  
  CONCLUSIONS
  trauma remains more common in younger populations and in males. There was a reduction of penetrating liver trauma. NOM proved safe and effective, and often has been used to treat patients with penetrating liver trauma. Morbidity was high and mortality was higher in victims of blunt trauma and complex liver injuries.
authors.forename: Thiago Messias
authors.initials: TM
authors.lastname: Zago
authors.forename: Bruno Monteiro
authors.initials: BM
authors.lastname: Pereira
authors.forename: Bartolomeu
authors.initials: B
authors.lastname: Nascimento
authors.forename: Maria Silveira Carvalho
authors.initials: MS
authors.lastname: Alves
authors.forename: Thiago Rodrigues Araujo
authors.initials: TR
authors.lastname: Calderan
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; D013997:Time Factors; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000453:epidemiology* / Q000601:surgery; D014950:Wounds, Penetrating / Q000453:epidemiology* / Q000601:surgery