LIVER TRAUMA

LIVER TRAUMA

Liver injury due to blunt or penetrating abdominal trauma is second in frequency only to that of the spleen. Blunt injury produces contusion, laceration and avulsion, often associated with splenic, mesenteric or renal injuries. Penetrating injuries, including stab and gunshot wounds, are often associated with chest or pericardial involvement. Blunt injuries are more common and have a higher mortality ( Table 69.4 ).

TABLE 69.4 Mortality from liver trauma. Type of injury Mortality Blunt abdominal trauma Overall mortality 10–30% Severe and high-velocity injuries Up to 60% Injury to main hepatic veins or 50–100% retrohepatic inferior vena cava Penetrating injuries 12–20% 20–40% Penetrating injuries with associated duodenal, pancreatic or chest involvement; multiple stab wounds