Conservative Management in Blunt Liver Injury in Aldiwaniyah Teaching Hospital

  • Dr. Ali Abdul-Hussein Handoz M.B.Ch.B F.I.C.M.S, Teacher at medical college-AL-Qadysia university
  • Dr. Mohanad Gubari Zakuit M.B.Ch.B F.I.C.M.S. ( General Surgery ), Al- Diwaniya Health Directorate
  • Dr. Mohammed Hemzah Obayes Immunology Department of Medical Laboratories Techniques, Imam Ja'afar Al-Sadiq University, Al-Muthanna 66001, Iraq
Keywords: hepatic trauma, management, patients


Background: Blunt hepatic trauma is common in abdominal injuries. This study was conducted in those patients of blunt liver trauma to assess the effectiveness of conservative treatment.

 Methods: fifty patients with blunt hepatic trauma were included in this study. Clinical assessment was done in all the patients. FAST and CT scan were also done. Patients with unstable hemodynamics who responded to fluid challenge and with stable hemodynamics were included in conservative management of liver trauma.

 Results: In this study 50 patients were analyzed, 5 patients were operated due to unstable hemodynamics while 45 patients treated conservatively. Average numbers of blood units transfused were 2-3 units and average hospital stay was 3-6 days. 

 Conclusions: The conservative treatment is safe option for blunt hepatic trauma patients in patients with stable hemodynamics. Intensive monitoring is essential as there may be failure in a few patients. The complication rate was minimum and no mortality.   


1. Knudson MM, Lim RC, Jr, Oakes DD, et al. Nonoperative management of blunt liver injuries in adults: the need for continued surveillance. J Trauma 2004; 30:14941500.
2. Pachter HL, Spencer FC, Hofstetter SR, et al. Significant trends in the treatment of hepatic trauma: experience with 411 injuries. Ann Surg 2000; 215:492-502.
3. Durham RM, Buckley J, Keegan M, et al. Management of blunt hepatic injuries. Am J Surg 2002; 164:477-481.
4. Meredith JW, Young JS, Bowling J, et al. Nonoperative management of blunt hepatic trauma: the exception or the rule? J Trauma 1994; 36:529-535. 5. Flint LM, Mays ET, Aaron WS, et al. Selectivity in the management of hepatic trauma. Ann Surg 2003; 185:613-618.
6. Bismuth IL Surgical anatomy and anatomical surgery of the liver. World] Surg 2000;6:3.
7. Cogbill TII. Moore EE, ]w:kovich GJ, et al. Severe hepatic trauma: a multicenter experience with 1,335liver injuries. J 17aama 2004;28:1433.
8. Duane TM. Como ], Bochicchio G\1,' et aL Reevaluating the management and outcomes of severe blunt injury. J 17aama 2004;57:494.
9. Engrav LH, Benjamin Cl, Strate RG, et a!. Diagnostic peritoneal lavage in blunt abdominal trauma.] 1huuna 2005;15:854.
10. Gao ]M. Du DY; Zhao XI. et al. liver trauma: experience in 348 cases. WmldJ Swg2003;27:703.
11. Bajec DD, Radenkavic DV, Greqoric PD, Jeremic VM, Djukic VR, Ivanceic ND. Surgical treatment of liver injury: 5 years’ experience. Acta Chir Lugosl. 2010;57(4):9-14.
12. Pringle JH. Notes on the arrest of hepatic hemorrhage due to trauma. Ann Surg. 1908;48:541-9.
13. Girgin S, Gedik E, Tacyildic IH. Evaluation of surgical methods in patients with blunt liver trauma. Ulus Travma Acil Cerrahi Derg. 2006;12(1):35-42.
14. Daniale E, Dissanaike S. Bioglue for traumatic liver lacerations. Int J Surg Case Rep.
15. Asensio JA, Demetriades D, Chahwan S, Gomez H, Hanpeter D, Velmahos G. Approach to management of complex hepatic injuries. J Trauma. 2000;48(1):66-9.
16. Polanco P, Leon S, Pineda J, Puyana JC, Ochoa JB, Alarcon L. Hepatic resection in the management of complex injury to the liver. J Trauma. 2008;65(6):1264-9. 17. Holmes JH 4th, Wiebe DJ, Tataria M, Mattix KD, Mooney DP, Scaife ER, et al. The failure of nonoperative management in pediatric solid organ injury: a multi-institutional experience. J Trauma 2005;59:1309-13.
18. Malhotra AK, Latifi R, Fabian TC, Ivatury RR, Dhage S, Bee TK, et al. Multiplicity of solid organ injury: influence on management and outcomes after blunt abdominal trauma. J Trauma 2003;54:925-9.
19. Cox JC, Fabian TC, Maish GO 3rd, Bee TK, Pritchard FE, Russ SE, et al. Routine follow-up imaging is unnecessary in the management of blunt hepatic injury. J Trauma 2005;59:1175-80.
20. Shapiro MB, Nance ML, Schiller HJ, Hoff WS, Kauder DR, Schwab CW. Nonoperative management of solid abdominal organ injuries from blunt trauma: impact of neurologic impairment. Am Surg 2001;67:793-6.
21. Becker CD, Mentha G, Terrier F. Blunt abdominal trauma in adults: role of CT in the diagnosis and management of visceral injuries. Part 1: liver and spleen. Eur Radiol. 1998;8:553Y562.
22. Wallis A, Kelly MD, Jones L. Angiography and embolization for solid abdominal organ injury in adultsVa current perspective. World J Emerg Surg. 2010;5:18.
23. Ochsner MG. Factors of failure for non-operative management of blunt liver and splenic injuries. World J Surg. 2009;25:1393Y1396.
24. Nance ML, Peden GW, Shapiro MB, et al. Solid organ injury predicts major hollow viscous injury in blunt abdominal trauma. J Trauma. 2000;43:618Y625.
25. Miller PR, CroceMA, Bee TK, et al. Associated injuries in blunt solid organ trauma: implications for missed injury in non-operative management. J Trauma. 2002;53:238Y244.
How to Cite
Handoz, D. A. A.-H., Zakuit, D. M. G., & Obayes, D. M. H. (2023). Conservative Management in Blunt Liver Injury in Aldiwaniyah Teaching Hospital. Central Asian Journal of Medical and Natural Science, 4(3), 284-291.