Mumtaz Khan, Sajjad Mohammad Khan.
Pattern and management of hepatic injuries in North West of Pakistan.
J Postgrad Med Inst Jan ;15(1):18-28.

Forty consective patients with liver injuries were studied in a period of fourteen months i.e. 1st June 1997 to 31st July 1998. Majority of the patients were young male adults with mean age of 30 years (range 1617 years). Male of female ratio was 9:1. Thirty three patients (82.5%) had penetrating injuries and 7 had substained blunt trauma. Twenty five (62.5%) patients were in a state of shock at the time of arrival, in emergency department, with stock index > 1. Injury severity score was 29.1. All patients had to be explored surgically in casualty operation theatre. Right lobe was injured in 67.5% while left in 30% of cases. Twenty seven patients (67.5%) had other associated injuries (other organs in addition to liver). Average number of organs injured per patient was 2.75. Twenty seven patients (67.5%) had sustained simple liver injuries and were managed by simple, technique of hepatic repair. Thirteen patients (32.5%) had complex liver injuries and had to have more complex surgical procedure i.e. extensive hepatorrhaphy, resection/ debridement and selective hepatic artery ligation). Post operative complications were wound infection, wound dehiscence, post operative bleeding form liver, intra-abdominal sepsis, biliary leak and jaundice. Five patients died (mortality 12.5%). Mortality was high in patients with complex liver injuries, advance age in those with blunt trauma.

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