Журнал травм и лечения

Blunt Trauma Liver-Conservative or Surgical Management: A Retrospective Study

Abstract

Sreeramulu PN, Venkatachalapathy TS and Anantharaj

Background: The liver is one of the most frequently damaged organs and remains the most common cause of death following blunt abdominal trauma. Currently, a conservative management constitutes the treatment of choice in patients with hemodynamic stability. The aim of this study is to evaluate the results of an operative and conservative management of 55 patients with liver injury treated in a single institution.
Methods: A retrospective study of the patients presented with blunt liver trauma was performed from 2008-2012. The patients were categorised according to the mode of treatment received. Group I: Conservative management; Group II: Operative management. Variables analyzed included demographic data, cause of injury, grade of injury, associated injuries, vitals, haemoglobin values, mode of treatment and complications.
Results: A total of 55 patients were analyzed. 16 patients had sustained severe injuries. Mean pulse rate in conservative and operative group was 92 and 102 beats/min respectively. Mean blood pressure in conservative and operative group was 110/70 and 90/60 mmHg respectively. Conservative treatment was followed in 28 patients with surgery undertaken in 6 of the patients from this group due to failure of conservative treatment. Immediate surgery was carried out in 27 patients. Mortality occurred in 8 patients. Morbidity occurred among 5 patients in conservative group and among 8 patients in operative group. Mean duration of hospital stay in conservative and operative groups are respectively 17 and 19 days. P value is significant (0.04).
Conclusions: Conservative treatment is an adequate treatment in mild to moderate liver injury patients. Failure of conservative treatment did not show a higher incidence of complications or mortality but it should be performed in centres with experienced surgeons.