Traumatic injuries to the liver occur commonly in our motorized and violent society. Trauma to the liver carries a high mortality. There is no good indication for hepatic resoction in emergency cases. The purpose of this study is to analyze the
factors
that determine the mortality and morbidity of patients who sustain hepatic injuries and to purpose a program for their management based on the categorization of these injuries according to their severity.
One hundred twenty six patients of traumatic liver injury underwent treatment from Jan. 1983 to Dec. 1992 at Department of Surgery, Pusan National University Hospital.
@ES The following results wee obtaind:
@EN 1) The peak age incidence was 3rd decade 32 cases (25.4%) and sex ratio of male to female was 4.2:1.
2) In the causes of injury, blunt abdominal trauma were 107 cases (84.9%) and penetrating abdominal trauma were 19 cases (15.1%).
3) Abdominal tenderness and rebound tenderness were exerted in 125 cases (99.2%), 98 cases (77.8%) respectively. Other clinical symptoms were abdominal distention, dyspnea and chest discomfort and so on.
4) The degree of injury were classified by AAST (American Association for the Surgical Trauma). There were 27 cases (21.4%) in type I injury, 21 cases (16.7%) in type II, 42 cases (33.3%) in type III, 26 cases (10.6%) in type IV, 8 cases (6.2%)
in
type
V and 2 cases (1.6%) in type VI.
5) Conservative treatment was done in 5 cases (4.0%). Surgical managed patient were divided two groups, resectional and non-resection group, 19 cases (15.1%), 102 cases (80.9%) respectively.
6) Postoperative complication were 27 cases (21.4%) in respiratory failure, 26 cases (20.6%) in bile leakage, 17 cases (13.5%) in wound infection, 12 cases (9.5%) in renal failure. There was meaningful relationship between preoperative shock
episode
and complication (P<0.01).
7) The rate of mortality was highest in type VI injury (50%). The causes of death were adult respiratory distress syndrome 9 cases (7.1%), renal failure 8 cases (6.3%), sepsis 7 cases (5.6%), hepatic failure 6 cases (4.8%) and so on.
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