Surgical management such as hemostasis, removal of devitalized tissue and drainage has been generally accepted method for treatment of traumatic liver injuries.
At the time of exploration, however, the injury is frequently found to be relatively minor and the bleeding has ceased. In this situation, no further surgical manipulation may be necessary. Moreover, utilization of computerized tomography in
blunt
abdominal injuries contributes to more accurate assessment of the magnitude of intraperitoneal organ injuries, especially the liver injuries as well as other intraperitoneal solid organ injuries. In this respects, nonoperative management for
treatment
of blunt hepatic injures has been attempted recently, and successful results have been reported in many series.
Forty five patients of traumatic liver injuries were treated at the department of general surgery, Fatima Hospital from January 1985 to December 1990. Of 45 patients, 19 were treated with nonoperative management. According to CT finding, 4 of
subcapsular hematoma, 6 of intrahepatic hematoma and 9 of simple laceration of liver with hemoperitoneum confined to Morison's pouch were treated with nonoperative management.
All of the nonoperatively managed 19 patients have no significant complications such as delayed bleeding, hepatic abscess, hemobilia and sepsis, the hospitalization was ranged from 6 days to 34 days with average of 17.5 days.
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