The hepatic injury incurred in blunt abdominal trauma continues to carry a significant mortality and morbidity despite advances in both diagnostic and therapeutic method employed in its management. This hepatic injury is associated with multiple
organ
injury, so that the factors determining the mortality and morbidity in hepatic injuries are important to predict the prognosis and decide the nonoperative management. The experience with 81 cases of hepatic injuries were reviewed retrospectively.
The 81
patients were identified with blunt trauma that had been confirmed by abdominal exploration or abdominal computed tomography: 60 were underwent operation, and 21 were managed nonoperatively only if they were hemodynamically stable and had no
significant
peritoneal irritation. The morbidity was 39.5% and the mortality was 21.0. the associated injury was 21 extraperitoneal cases in the 13 nonoperatively managed patients, and 91 extraperitoneal cases, 26 intraperitoneal cases in the 60 operatively
managed
patients. Two groups of patients could be analysed in terms of their vital sign, biochemical laboratory rinding including liver function test, trauma scores including the physiologic and anatomic scores and demographic factors, etc. Available
factors
affecting the prognosis was systolic blood pressure, base excess, sGOT(serum glutamic-oxaloacetic transaminase), sGPT(serum glutamic-pyruvic transaminase), trauma scores, amount of transfusion, grade of liver injury, mentas status and operative
gap.
Available factors determining the nonoperative managemet was systolic blood pressure, base excess, trauma scores, age, amount of transfusion, grade of liver injury and mental status involving cranial injury.
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