Liver Trauma

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Abstract
Two hundred eighty-five cases of liver trauma have been treated in the last five years at the San Francisco General Hospital. One hundred three resulted from blunt trauma and 182 from penetrating wounds. The average age was 29 years. Fifty-eight percent of the patients were treated with drainage, 28% by resectional debridement, and 14% by major resection. Associated injuries occurred in 212 patients (74%). Twenty-nine patients (10%) died in the operating room from exsanguination and 23 (9%) postoperatively from head injury, sepsis, and pulmonary insufficiency. The overall mortality was 18.8%. The indications for liver resection in trauma include the following: deep lacerations with involvement of major vascular structure or bile ducts, lacerations which produce nonviable liver segments, and lacerations with massive hemorrhage which are associated with vena cava or hepatic vein injury.

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