title: Management and treatment of liver injury in children.
abstract: BACKGROUND
  We aimed to assess the causes of trauma that result in liver injury and additional solid organ injuries, management types and results of management in children referred to our clinic for liver injuries.
  
  
  METHODS
  The records of 52 patients who were managed for liver injuries due to blunt abdominal trauma between January 2005-2010 were reviewed retrospectively.
  
  
  RESULTS
  The patients were 1-17 (8.3±5.4) years old; 32 (62%) were male and 20 (38%) were female. Causes of injuries included pedestrian traffic accidents (19, 37%), falls from height (15, 29%), passenger traffic accidents (8, 15%), bicycle accidents (8, 15%), and objects falling on the body (2, 4%). Isolated liver injury was present in 32 patients (62%), while 20 patients (38%) had other organ injuries. Liver injuries were grade I in 6 patients (12%), grade II in 14 (28%), grade III in 22 (43%), grade IV in 9 (17%), and grade V in 1 (2%). Forty-five patients (87%) were managed conservatively in this series of liver injury, whereas seven patients (13%) who had unstable vital signs underwent surgery. The mortality rate, duration of stay in intensive care and hospital, and number of blood transfusions were higher in surgically managed patients, while hemoglobin level and blood pressure were significantly lower in surgically managed patients.
  
  
  CONCLUSIONS
  As a result, conservative management should be preferred in patients with liver injuries who are hemodynamically stable. Conservative management has some advantages, including shorter duration of stay in hospital, less need for blood transfusion and lower morbidity and mortality rates.
authors.affiliation: Department of Pediatric Surgery, Dr. Münif İslamoğlu Kastamonu State Hospital, Kastamonu, Turkey. drserkanarslan@hotmail.com.
authors.forename: Serkan
authors.initials: S
authors.lastname: Arslan
authors.affiliation: Department of Pediatric Surgery, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Güzel
authors.affiliation: Department of Pediatric Surgery, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors.forename: Cüneyt
authors.initials: C
authors.lastname: Turan
authors.affiliation: Department of Radiology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Doğanay
authors.affiliation: Department of Pediatric Surgery, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors.forename: Ahmet Burak
authors.initials: AB
authors.lastname: Doğan
authors.affiliation: Department of Pediatric Surgery, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Aslan
mesh_terms: D000007:Abdominal Injuries / Q000601:surgery*; D000059:Accidents; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008099:Liver / Q000293:injuries* / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014949:Wounds, Nonpenetrating / Q000601:surgery*