Liver Trauma Usually Means Management of Multiple Injuries: Analysis of 78 Patients

The liver is the second most traumatized organ in the abdominal cavity. The authors present a retrospective analysis of a group of 78 patients treated for this injury at one institution. In this group, there were 5 (6.41%) penetrating and 73 (93.59%) blunt trauma injuries. The mean Injury Severity Score (ISS) of the group was 31.6. Isolated liver trauma occurred in only three (3.84%) cases. At the same time, chest injury occurred in 89.84%, head injury occurred in 74.64%, limb injury occurred in 32.05%, and spinal or pelvic injury occurred in 26.92% of patients. Trauma to other intra-abdominal organs was found in 82.97% of patients, and surgical intervention was necessary in 51.06%. The routine use of helical computed tomography with contrast showed a sensitivity of 88.76% and 95.50%, respectively. Liver bleeding resulted in three (3.84%) patient deaths. Overall mortality was 29.48%. The mean period of hospitalization on the intensive care unit was 27.42 days. At present, liver trauma cannot be separated from multiple injuries; morbidity and mortality depend more on the affiliated trauma than on specific liver injury.