Outcome and management strategy of traumatic liver injury in a tertiary hospital in Bangladesh

Authors

  • HA Nazmul Hakim Assistant Professor, Department of surgery, Dhaka Medical College Hospital, Dhaka
  • Kazi Mazharul islam Medical Officer, Department of Surgery, Dhaka medical college and hospital, Dhaka
  • Md Aminul islam Registrar, Department of Surgery, Dhaka medical college and hospital, Dhaka
  • ANM Nure Azam Assistant Registrar, Department of surgery, Dhaka Medical College Hospital, Dhaka
  • Md Tuhin Talukder Medical Officer, Department of Surgery, Dhaka medical college and hospital, Dhaka
  • Mohammad Mahmud Sarder Medical Officer, Department of Surgery, Dhaka medical college and hospital, Dhaka

DOI:

https://doi.org/10.3329/jss.v22i1.44013

Keywords:

Liver trauma; damage control resuscitation; perihepatic packing, trauma surgery

Abstract

Background: Liver remains the second most common injured organ in both blunt and penetrating trauma of the abdomen. Management of blunt or penetrating injury to the liver remains a significant challenge to trauma surgeons. Unstable patients require immediate laparotomy. Selective patients can be managed without surgery and with careful monitoring. Mortality is mainly due to damage to major hepatic blood vessels, massive parenchymal and biliary injury. Associated non-hepatic injuries contribute greatly to the overall mortality. With improved understanding of the major causes of mortality from hepatic injury, adequate resuscitation, well planned surgical intervention and better intensive care facilities have decreased mortality and morbidity

Objectives: Performed to assess incidence, mechanisms, management and outcome of traumatic liver injury. Methods: This prospective study was performed in Dhaka Medical College Hospital between January 2013 to December 2014. Sixty patients with hepatic injury were included in the study. Data collected in data collection sheet regarding demographic data, severity of liver injury, hemodynamic status on admission, investigations reports, concomitant injuries, management scheme, and outcome of patients which were then analyzed.

Results: There were 39 male and 21 female patients with a mean age of 31.3 (SD=15.4) years. Road traffic accident was the most common injury mechanism (71%). 20 patients (33%) were in shock at the time of admission. 48 patients (80%) with liver injury had associated injuries of other organs. Majority of the patients (41%) were found with grade Ill injury. 50 patients (83%) needed surgical interventions. Most common (16%) complication was wound infection. 3 patients (5%) died in this series. 5 patients (8%) developed liver abscess on subsequent follow up. Conclusion: Most of the trauma victims are young and in the active state of life. Prompt resuscitative measures, assessment of extend of hepatic injury and associated injuries, well justified surgical intervention along with critical care support can contribute greatly to the survival of victims of hepatic injury.

Journal of Surgical Sciences (2018) Vol. 22 (1): 36-42

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Published

2020-03-22

How to Cite

Hakim, H. N., islam, K. M., islam, M. A., Azam, A. N., Talukder, M. T., & Sarder, M. M. (2020). Outcome and management strategy of traumatic liver injury in a tertiary hospital in Bangladesh. Journal of Surgical Sciences, 22(1), 36–42. https://doi.org/10.3329/jss.v22i1.44013

Issue

Vol. 22 No. 1 (2018)

Section

Original Articles

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