A Clinical Analysis of the Traumatic Injuries of the Liver

The traumatic liver injury rising rapidly in its frequency with the increase of traffic accident, industrial accident and violence, etc. Mortality rate due to liver injuries has decreased due to the speedy transpotation and improvement in management, but about 15 to 30% of the mortality rate is still noted.

The report a clinical study of experiences with 19 cases of liver injuries which were treated by surgical intervention at the Ewha Womans University Hospital from January 1977 to June 1978.

The following results were obtained:

1) The sex distribution was 16 males and 3 females with a significant high incidence in male and ratio 5.3:1 and the age distribution revealed a high incidence in the 2nd decade.

2) The seasonal distribution showed that liver injury was more prevalent in summer season, comparative statistics for the 7 years suggested that the liver injury has been gradually increasing recently.

3) The nature of the injury was blunt trauma in 17 cases(89.47%) and penetrating injury in 2 cases(10.53%) respectively. There were 15 cases of traffic accident trauma. There were 2 industrial accident, and all the penetrating injury was made with knife, no gunshot injury was noted.

4) There was predilection between the right lobe(84.21%) and the left lobe(36.84%) while there was incidence of bilateral involvement of the liver(21.05%)

well related to the mortality rate. The chest injury was the most common among the associated injures.

6) The peritoneal irritation sign was present in the majority of the case(94.74%) and 72.73% of the cases were diagnosed with paracentesis with most probable diagnostic accuracy.

7) 14 cases of patients were admitted within 6 hours after injury.

8) In most cases suture repair, adequate hemostasis and drainage procedure were employed but in 3 cases, common bile duct was exploration and cholecystectomy needed and also 2 cases, hepatic resection and 5 cases, segmental resection was performed.

9) The incidence of postoperative complication was 36.84%(7 cases) and common complication were wound infection, intestinal obstruction and persistant bleeding.

10) The overall mortality rate was 15.79%(3 cases) and this 3 cases of the associated injuries of other organs were noted.