Profile of Management Strategies in Liver Trauma

Background: Liver injuries are common following various abdominal traumas, particularly after vehicular accidents. Conservative approach is preferred these days instead of the earlier protocol of operative intervention. Aim: To find out profile of presentation and management of patients presenting with liver trauma. Material and methods: One hundred consecutive patients of liver injury were prospectively included in the study. A conservative or operative management was decided basedon their clinical and radiological picture. The events at presentation during hospitalisation, at surgery and their outcome were recorded and evaluated. Results: of the hundred patients, 65 were initially put on non operative management. Eight of them subsequently needed surgeryforassociated non hepatic injuries, and 6 others having isolated hepatic injuries were operated for haemodynamic instability and were labelled as failure of non operative management. The remaining 51 were successfully managed on non operative management. Adverse outcome in the form of complications and mortality were higher in the operative group. Conclusion: Non operative treatment should bd the preferred option whenever patient is haemodynamicaly stable. Liver injuries with associated major organ injuries should be managed in specialise trauma units with facilities of intensive care and high dependency units.