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Nonoperative Management

Jerome P. Richie, MD; Eric W. Fonkalsrud, MD

AMA Arch Surg. 1972;104(6):781-784.

Abstract
Hepatic injury is a common sequela to blunt abdominal trauma and presents a diagnostic and therapeutic challenge. Although early abdominal exploration usually is recommended when hepatic injury is suspected, a few patients will experience subcapsular hematoma without laceration. Surgical management of such patients is less clearly defined. The present report summarizes the experience at the UCLA Hospital with four patients who sustained subcapsular hematomas of the liver after blunt trauma. Each patient was managed by careful observation, sedation, and nasogastric decompression, with gradual resolution of the hematoma as seen on serial liver scans. In selected patients with subcapsular hematoma of the liver, nonoperative management may be desirable.

Author Affiliations
Los Angeles

From the Department of Surgery, UCLA School of Medicine, Los Angeles.

Footnotes
Accepted for publication Feb 15, 1972.

Read before the annual meeting of the Southern California Chapter of the American College of Surgeons, Santa Barbara, Calif, Jan 16, 1972.

Reprint requests to UCLA School of Medicine, Center for Health Sciences, Los Angeles 90024 (Dr. Fonkalsrud).

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