BLUNT HEPATIC INJURY

  • 1 January 1978
    • journal article
    • research article
    • Vol. 67  (2) , 66-69
Abstract
Blunt hepatic injuries (56 cases) occurred in 255 laparotomies on patients with multiple injuries. Pre-operatively, 1/2 of the patients were in profound shock; hepatic bleeding was often accompanied by bleeding in other sites, usually from a ruptured spleen or into a retroperitoneal hematoma. Diagnosis was aided by laparocentesis and peritoneal lavage. In 3 cases the diagnosis was delayed for 8-12 h. The lacerations were sutured in 43 cases, a local resection was made in 10 cases and a lobar resection in 3 cases. Manual compression of the liver was the best way of achieving temporary hemostasis. In cases where hemodynamic stability was not achieved post-operatively, immediate re-operation to attain hemostasis was definitely advantageous. The mortality from multiple blunt injuries was high (17%) but especially so in cases with hepatic injury (41%). Liver injuries after blunt trauma can often be managed by suturing; hepatic resection is seldom necessary.

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