Hepatic trauma

S. C. Stain, A. E. Yellin and A. J. Donovan
Department of Surgery, University of Southern California School of Medicine.

Two hundred thirty-three patients were operated on for hepatic trauma during a two-year period. There were 101 patients with stab wounds, 90 with gunshot wounds, and 42 with blunt trauma. There were 56 isolated liver injuries. Three hundred seventy-five associated injuries occurred among the remaining 177 patients. The majority of patients required only drainage. "Liver sutures" were employed in 66 patients. Only 18 patients required debridement, resection, or packing. Twenty-eight patients (12%) died. Perioperatively, 13 patients died of hemorrhage from the hepatic wound and from the associated major vascular injuries that were present in eight of the 13 cases. The remaining deaths were not primarily a consequence of the hepatic wound. Control of hemorrhage remains the dominant consideration in the treatment of major hepatic wounds.