Introduction. Trauma is a leading cause of death, particularly among young patients. Spleen is the most commonly damaged organ in blunt abdominal trauma and liver injury is the main cause of death.
Aim of the study. Review of the literature and recent clinical experience in the management of blunt liver injuries in the Riga East clinical university hospital.
Materials and methods. Three-year experience in the management of liver traumatic rupture was retrospectively and prospectively analysed. The study included 64 patients over 15 years of age with blunt hepatic injuries. Exclusion criteria were patients with life-incompatible haemorrhagic shock. The Statistical analysis of the data was performed by median and mean of the Microsoft Excel 2010 and SPSS 22 version.
Results. A total of 64 patients were treated in our institution during the period from November 2010 till November 2013. Isolated liver injuries were diagnosed in 49 cases, combined liver and spleen injuries in 15 cases. Most commonly mechanism ofinjury were road traffic accidents, falls and low energy blunt traumas (criminal beaten, sports injuries);19 patients underwent laparotomy for haemostasis while nonoperative management was used in 45 patients. Haemodynamic stability of the patient and CT confirmed liver injury were the main criteria for nonoperative management. One patient died atthe time of laparotomy from injuries not compatible with life – severe head injury with basal skull fracture, aortic arc rupture, flail chest and liver and spleen injury.
Conclusions. Conservative management of liver trauma is justified in haemodynamically(HD) stable patients after thorough risk assessment and computed tomography (CT) based injury grading in centres with sufficient expertise and medical resources.
