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Trauma, Vol. 9, No. 3, 171-180 (2007)
DOI: 10.1177/1460408607086775
© 2007 SAGE Publications

Liver trauma

I Ahmed

Department of HPB Surgery, Queens Medical Centre, Nottingham University Hospitals, Nottingham, NG7 2UH, United Kingdom, irfan.ahmed{at}nuh.nhs.uk

IJ Beckingham

Department of HPB Surgery, Queens Medical Centre, Nottingham University Hospitals, Nottingham, NG7 2UH, United Kingdom

Management of blunt or penetrating injury to the liver remains a significant challenge to trauma surgeons. Liver injury remains common in both blunt and penetrating trauma of the abdomen. Unstable patients require immediate laparotomy. Selective patients can be managed without surgery and with careful monitoring. There has been a recent resurgence in the role of temporary packing in the management of liver trauma. Other commonly used techniques are resectional debribement and suture ligation of bleeding vessels. Complications include haemorrhage, bile leak and sepsis. Mortality is mainly due to damage to major hepatic blood vessels or other associated non-hepatic injuries. With improved understanding of the major causes of death from hepatic injury, improved resuscitation and intensive care, mortality has fallen below 10%.

Key Words: liver • liver trauma • trauma surgery • damage control • permissive resuscitation • packing • perihepatic packing


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