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Study of Outcome in Patient of Grade-3 & 4 Liver Injuries in Blunt Abdomen Trauma

Jigneshkumar Thakarshibhai Patel, Resident, Department of Surgery, Pandit Deendayal Upadhyay Medical College, Rajkot, Gujarat 360001, India. , Swastik Sankhala1 , Jigneshkumar Thakarshibhai Patel2

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New Indian Journal of Surgery 9(5):p 644-648, Sep-Oct 2018. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9518.19

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Abstract

Background and Aim: Road traffic accidents are commonest cause resulting Blunt Abdominal trauma. Liver injury is second most common solid organ injury in blunt abdomen trauma after spleen. Latent period,vital status and associated organ injuries and grade of liver injury decide the outcome of patients. Present study was performed with an aim to ascertain conservative or operative approach of management of liver trauma with help of investigating modalities haemodynemic status of patients and associated injuries. Materials and Methods: This prospective study was conducted in 30 patients presenting with liver injury in blunt abdominal trauma during the period from May 2015 to january 2018 at P.D.U. Government
Medical College and Hospital, Rajkot. Data were collected from the patients by their history, examination and appropriate investigations. Documentation of patients, which included history, vitals of patients, clinical findings, blood investigations, diagnostic tests, intraoperative findings, operative procedures were all recorded on a Performa specially prepared. Results: out of 30 cases, 24 were males accounting 80% of study populations and 6 (20%) were females. Mean age in present study was 29.22years. In 20 (66.67%) cases, road traffic accident was the most common mode of injury. Mean latent period was 4.68 hours. Out of 30 cases 23 patients having grade 3 & 7 patients having grade 4 liver injury. USG was done in 30 cases and computed tomography Abdomen was done in 28 patients. 86.67% managed by non-operative management as they were  hemodynamically stable and Primary operative management group includes (13.33%) primarily underwent operative management as they were hemodynamically unstable at presentation in liver grade 3 & 4. Conclusion: In Patients with high grade liver injuries, better investigation modalities, hemodynamic stability by proper resuscitation and blood transfusion can be managed with conservative approach which decreases significanty morbidity and mortality of patients in hemodynamically stable patients. 

Keywords: Blunt Injury; Diagnostic Modalities; Liver Trauma; Mortality.  

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9518.19

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