Blunt Hepatic Trauma: Suggested Algorithm for Surgical and Nonoperative Management

Abstract

ABSTRACT Objective This study aims to analyze the outcomes of blunt hepatic trauma, and compare operative treatment (OT) and nonoperative management (NOM) emphasizing the stratified results by grade of injury and failure rate. Materials and methods This is a prospective study of cases admitted to João XXIII Hospital, located in Belo Horizonte, Brazil, from January 2013 to December 2013. Patients were admitted with blunt hepatic trauma on emergency room (ER) and were divided into two groups. One group contained patients who met the criteria for NOM, and the other group was formed by patients with surgical indication. Results During the study period, 47 patients were admitted with blunt liver injury and 43 (91.4%) met the inclusion criteria for NOM. The rate of NOM failure was 9.3%: 50% of them had grade II injury and 50% had grade V. The patients with grade II injury had also extrahepatic lesions and, in those with grade V, the failure was due to bleeding. Conclusion Nonoperative management has become the standard of care for patients with blunt liver injuries in trauma centers. However, as grade V injuries have a higher failure rate, they might receive special attention from the surgical team. How to cite this article Azevedo CI, Franciscani AAR, Souza AB, Filho FMB, Starling SV, Drumond DAF. Blunt Hepatic Trauma: Suggested Algorithm for Surgical and Nonoperative Management. Panam J Trauma Crit Care Emerg Surg 2015;4(1):1-5.