Comparison of non-operative and operative management of isolated liver injury in blunt abdominal trauma
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 9, Pages 2980-2987
AbstractAim: The aim of the study was to analyze the effectiveness and morbidity and mortality of both non-operative management as well as operative management of liver injury patients admitted to our hospital.
Material and methods: This Prospective observational study was done in the Department of Surgery, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India, for 12 months. 50 patients aged between 18-65 years of both sex with isolated liver injury due to blunt abdominal trauma with or without associated injury were included in this study. All 50 patients were subjected to radiological investigation with focussed assessment sonography for trauma (FAST) in hemodynamically unstable patients and contrast- enhanced computed tomography (CECT) abdomen in hemodynamically stable patients. All injuries were classified according to the American Association for the Surgery of Trauma (AAST). Results: The majority of the patients (46%) belonged to 20-30 years age group, followed by 10-20 and 30-40 years age group (18%). The majority of patients were male 90% whereas female patients were only 10% (Table 2). MVA was responsible for 80% of blunt abdominal trauma cases, while fall from height accounted for 20% of cases. Majority of the patients presented with abdominal pain (100%) and abdominal tenderness (100%). Associated extra-abdominal injuries were found in 21 cases. All case-patients with head injury were managed conservatively with neurosurgery consultation. In present series, most of the liver injuries due to blunt trauma abdomen were minor type (grade I, II and III), they are (92%) of the total blunt liver injuries, major injuries (grade IV, V and VI were seen in (8%) cases of blunt liver trauma. In present series, the majority of the blunt liver injuries were grade II (46%), 1 (28%) and III (18%) injuries followed by grade IV (6%) and V injury (2%) have the lowest incidence.
Conclusion: Isolated liver injury is common in the blunt abdominal trauma patient. Most of the patients with the liver injury with hemodynamically stable treated conservatively. Only a few of them require surgical management if they are hemodynamically unstable.
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