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Year : 2019  |  Volume : 9  |  Issue : 3  |  Page : 84-88

Management of blunt liver trauma: Observational hospital-based study

Department of Surgery, GMC, Aurangabad, Maharashtra, India

Correspondence Address:
Dr. Anant N Beedkar
Department of Surgery, GMC Aurangabad-431 001, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ais.ais_35_19

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Background: Conservative management of blunt liver trauma is being recommended based on evidence from research studies. The present study describes the observations concerning the management of blunt liver trauma from a tertiary care centre in Marathwada region of Maharashtra. Patients and Methods: This observational hospital-based study included hemodynamically stable patients with confirmed blunt liver trauma, admitted at our tertiary care hospital. Patients who were not hemodynamically stable on admission; but later became hemodynamically stable after resuscitation were also included in the study. Hemodynamic stability was assessed based on systolic BP >90 mmHg; Pulse rate <100, and transfusion requirements <2 units. Diagnostic tools used were routine laboratory tests, Ultrasound imaging and CECT abdomen and pelvis. The AAST classification was used for grading the liver injury in patients in whom CT scan was done. Patients were assessed for clinical and hemodynamic status. Resuscitation, was done by using crystalloid solution and blood. The patients were then transferred to the intensive care unit for monitoring of vitals like pulse rate, systolic BP and abdominal distension. Regular observations and documentation of vital signs abdominal distension and haemoglobin were done, and once there is a change in the hemodynamic status patient was scheduled for surgical intervention. Patients were followed at 1, 2, 3, and 6 months interval. Results: Total 31 (29 males, 2 females) blunt liver trauma patients were included. In total 26 patients (83.9%) were managed conservatively. Five patients (16.1%) were operated based on hemodynamic parameters. Most of the patients with grade II, III and IV liver trauma were managed conservatively with satisfactory results. Conclusion: Study findings favour nonoperative management of blunt liver trauma in hemodynamically stable patients and also in patients who are responsive to resuscitation.

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