Assessment of Non-Operative Management Outcome of Liver Injury after Blunt Abdominal Trauma

Mohamed, Mohamed Ismail Abd El Aziz; Salah, Emad; Goda, Ashraf; Mansour, Mohamed Ibrahim

doi:10.21608/zumj.2023.237934.2907

Assessment of Non-Operative Management Outcome of Liver Injury after Blunt Abdominal Trauma

Document Type : Original Article

Authors

¹ General Surgery Resident Doctor, Kobri El Koba Military Hospital

² surgery department, faculty of medicine, zagazig university, zagazig, egypt

³ General Surgery Department, Faculty of Medicine, Zagazig University

⁴ General surgery department, faculty of medicine, zagazig university, Egypt

10.21608/zumj.2023.237934.2907

Abstract

Background: The non-operative management of liver injury after blunt abdominal trauma decreases the risk of laparotomy, as regards both the short and long-term outcomes. This work aimed to discuss the outcome of non-surgical management of liver injuries among patients with blunt abdominal trauma.

Subjects and methods: We performed this Cohort study on 30 patients with blunt abdominal trauma with liver injury at Zagazig University Hospital's surgical emergency unit. All patients were subjected to radiological investigations including abdominal ultrasound (U/S) and abdominal Computed tomography (C.T). Hemodynamically stable patients were selected for non-operative management which included monitoring of cases closely with serial physical examinations.

Results: Statistically significant increases in the frequency of grade 5, and frequency of severe peritoneal free fluid were found in the failed group than in the success group, with p-value (p<0.05) for each. Seven patients (23.3%) had complications, out of them 2 patients had hepatic necrosis, 2 patients had haemobilia, 2 patients had a peri-hepatic abscess and one patient had biliary fistula, 6 patients (20%) had failed conservative management, out of the 2 patients died, one patient biliary peritonitis, one patient missed small intestinal perforation and 2 patients hepatic necrosis.

Conclusion: Patients with stable hemodynamics can be treated with non-operative methods, whereas those with deteriorating hemodynamics or peritonitis symptoms should undergo surgery.

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