Management of traumatic liver injuries

Author:

Schweizer W1,Tanner S1,Baer H U1,Lerut J1,Huber A1,Gertsch Ph1,Blumgart L H1

Affiliation:

1. Department of Visceral and Transplantation Surgery, University of Berne, Inselspital, CH-3010 Berne, Switzerland

Abstract

Abstract Liver injuries in Europe are usually caused by blunt trauma and a high mortality rate is generally reported. The severity of liver injury in 175 patients was graded from I to V and the Injury Severity Score assessed. Seventy-five patients in a prospective study (1987–1990) were treated according to a defined protocol. Non-operative management was used for those who were haemodynamically stable on admission. In unstable patients who proceeded to surgery, liberal use of packing was made and a low threshold for relaparotomy employed. Increasing experience resulted in fewer indications for resection and a 40 per cent rate of non-operative treatment in the prospectively managed group. The overall mortality rate was 12 per cent (15 per cent in the retrospective and 8 per cent in the prospective group). Death in patients with multiple injuries should only rarely result from liver trauma.

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference35 articles.

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3. Leberverletzungen nach stumpfem Bauchtrauma;Mätsch;Unfallchirurgie,1982

4. Diagnostik und Therapie von Leberverletzungen beim polytraumatisierten Patienten;Schweizer;Helv Chir Acta,1989

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