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ORIGINAL ARTICLE
Year : 2013  |  Volume : 3  |  Issue : 2  |  Page : 118-123

Non-operative management of blunt liver trauma in a level II trauma hospital in Saudi Arabia


1 Department of General Surgery, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
2 Department of Radiology, Zagazig Faculty of Medicine, Zagazig University, Zagazig, Egypt
3 Department of Radiology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt

Correspondence Address:
Wagih Mommtaz Ghnnam
14 Gawad Hosney Street, Sherbin, Dakahlia
Egypt
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Source of Support: This research is approved by our hospital (Khamis Mushayt General Hospital research committee) no external funds used, Conflict of Interest: None


DOI: 10.4103/2229-5151.114271

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Background: To evaluate our experience with non-operative management of blunt liver trauma at a level II trauma hospital in the Kingdom of Saudi Arabia. Materials and Methods: We prospectively evaluated 56 patients treated for blunt liver trauma at our hospital over a 4-year period (April 2008 to April 2012). Patients who were hemodynamically stable [non-operative group I (NOP)] were treated conservatively in the intensive or intermediate care unit (ICU or IMCU). Patients who were hemodynamically unstable or needed laparotomy for other injuries were treated by urgent laparotomy [operative group II (OP)]. All NOP group patients had computed tomography (CT) of the abdomen with oral and intravenous contrast. Injuries grades were classified according to the American Association for the Surgery of Trauma (AAST). Follow-up CT of the abdomen was performed after 2 weeks in some cases. Results: A total of 56 patients were treated over a 4-year period. Twenty patients (35.7%) were treated by immediate surgery. NOP group of 36 patients (64.3%) were managed in the ICU by close monitoring. Surgically treated group had more patients with complex liver injury (90% versus 58.3%), required more units of blood (6.05 versus 1.5), but had a longer hospital stay (16.6 days versus 15.1 days). None of the patients from the non-operated group developed complications nor did they need operation. The only mortality (in two patients) was in the operated group. Conclusion: The NOP treatment is a safe and effective method in the management of hemodynamically stable patients with blunt liver trauma. The NOP treatment should be the treatment of choice in such patients whenever CT and ICU facilities are available.


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