Operative and Non-Operative Management of Blunt Liver Trauma: Our Experience

Authors

The Department of General Surgery, Ain Shams University, Egypt

Abstract

Abstract Background: In recent years, there is a success of Non-operative management of blunt liver trauma. Aim of Study: The aim of our study is to discuss our experience in Operative and Non-Operative management of Blunt liver Trauma. Patients and Methods: A prospective cohort enrolled twenty-seven patients with blunt liver trauma admitted to our hepato-biliary unit were managed with non-operative conservative management, Angioembolization or operative intervention. Results: The patients mean age was 31.1±7.51 years. Two (7.4%) patients were diabetic, three (11.1%) were hypertensive. Twenty-two (81.5%) patients Glasgow coma score >10. Twenty (74%) patients were managed Non-operatively. Nineteen (95%) patients had successful Non-operative management but one patient (5%)patient needed delayed operation. Seven (25.9%) patients were managed operatively. The most com-monly associated injury was chest (59.2%), head (33.3%), spleen (11.1 %) and kidney (3.7%). Liver related complications included biloma & pseudo-aneurysm. The overall mortality was (7.4%). Conclusion: NOM of blunt liver injuries in haemodynam-ically stable patients is safe and feasible. Haemodynamic instability, generalized peritonitis during resuscitation or associated intra-abdominal organ injuries requires early surgical intervention. Liver related complications contribute to failure of NOM. Associated extra-abdominal and intra-abdominal injuries do not interfere with non-operative management.v

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