Fraz Fahim, Mahmood Ayyaz, Syed Mazhar Abbas.
Presentation and management of hepatic trauma at Mayo Hospital.
J Postgrad Med Inst Jan ;19(1):23-9.

Objective: To find out the pattern, severity and outcome of hepatic trauma in our population. Material and Methods: This study comprised of 57 cases of hepatic trauma admitted to south surgical unit, Mayo Hospital Lahore from January 1996 to December 1998. After initial assessment and proper evaluation, patients were properly investigated and offered management accordingly. Data regarding the age, sex, urban or rural origin, time delay from injury to presentation, type and pattern of injury, hemodynamic status at presentation, resuscitation requirements, intraoperative findings and associated injuries was collected. A routine statistical analysis of the data was performed. A follow up of a minimum of six months was done, initially once fortnightly for three months and then monthly for three months. Results: Out of 57 patients, 50 were male and 7 were female. Most were in the young adult age group. Blunt (50.8%) and penetrating (49.2%) trauma were almost equally distributed. Roadside accidents (66.8%) accounted for the most frequent cause of hepatic trauma. Most frequently it took them 4 to 6 hours to reach the definitive care center. Forty three (75.5%) patients were in obvious shock at presentation. Out of 57 patients 6 were treated conservatively and the rest were offered surgical intervention. Common complications observed were hemorrhage (8 cases), sepsis (6 cases), jaundice (6 cases) and hypoglycemia (6 cases). Mortality rate was 18%. Conclusion: Hepatic trauma is not uncommon in abdominal trauma. The delay in the arrival to the hospital is mainly the cause of the worst outcome. Conservative management with haemodynamic stability is an important measure along with surgical intervention in the management of hepatic trauma.

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