Outcome of non-surgical management of liver injury in blunt abdominal trauma

Introduction: Injuries to the liver remain a major obstacle for the successful treatment of blunt abdominal trauma. In the early part of the 20th century, aggressive operative treatment was popular. However, following World War II, this was replaced by the use of non-operative strategies. Objectives: • To study the outcome of non-surgical management of liver injuries in blunt abdominal trauma. • To study the percentage of conservatively managed blunt trauma liver cases which had to be managed surgically later. Methods: This is a cohort study done in the department of general surgery, Govt Medical College, Kozhikode, where 100 patients of isolated blunt trauma liver was monitored and followed up for two to three weeks. The number of cases that has been successfully managed by conservative or surgical methods will be analysed and the percentage of cases that was managed surgically while on non-operative approach would also be assessed. Results: Of all 100 patients, 96 patients were managed non operatively out of which 2 patients had to be converted to laparotomy later. 94 patients who were managed by non-operative approach was successfully discharged with no mortality, however the 2 patients where non operative approach failed had expired in the postoperative period. 4 patients were hemodynamically unstable at presentation hence had to be managed by surgical means and here only 1 patient was discharged successfully wherein the other three patients had expired in the post-operative period. Conclusion: Non-operative approach should be the preferred method for managing hemodynamically stable patients and it is associated with a good prognosis and minimal mortality.