Recently the number of trauma patients and subsequently traumatic liver injury cases have increased due to traffic accidents, violences and industrial accidents. There is no good indication for hepatic resection in emergency cases. The sixty five
patients of traumatic liver injury from january 1990 to December 1994 (period II) were compared with fifty six patients from January 1985 to Decembel 1989 (period I) according to their clinical manifestations, diagnostic findings, vectors of
injury,
grade of injury and postoperative morbidity and mortality at Department of Surgery, Pusan National University Hospital. The prognostic factors were analysed in later period.
@ES The following results were obtained:
@EN 1) the peak age group was 3rd decade(26.8%) in period I and 4th decade(27.7%) in period II. The ratio of male to female was 4.1 : 1 in period I and 3.6 : 1 in period II.
2) The most common cause was traffic accidents at both period and abdominal tenderness with rebound tenderness was the most frequent sign(94.6%, 96.9%) and shock at admission was 26.8% in period I, 38.8% in Period II.
3) The most common associated organ injury was chest injury(39.3%) in period I, abdomimal injury(50.8%) in period II. The requency of associated abdominal injury was changed spleen, mesentery, bowel and pancreas in period I to mesentery, bowel
spleen
and pancreas in period II.
4) The degree of injury was classified by AAST(American Association for the Surgical Trauma) and the grade III injury was the most frequent at both period(33.9%, 32.3%).
5) The suture and drainage was employed for control of hemorrhage in 57.1% in period I and 47.6% in period II. The conservative treatment was significantly increased in later period.
6) The postoperative morbidity was 33.9% in period I and 35.4% in period II. The postoperative mortality was decreased in period II(15.3%) than period I (25.0%) and the most common cause of death was changed hypovolemic shock in period I to
adult
respiratory distress syndrome in period II.
7) Shock at admission was the most important factor and grade of injury, total amounts of transfusion were proved as another important affecting factors to morbidty and mortality in the liver injury.
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