Abstract
Fifty-two patients with hepatic trauma during the past 10 years were reviewed. The average age of the patients was 31 years, and the male to female ratio was 2.7:1. Penetrating wounds were present in 12 patients (23%), majority of which was caused by stab wounds and was included in Makiya's type 1 as for the injury type. Hepatorrhaphy was applied except for one case of partial resection as an operative procedure, resulting in two deaths. On the other hand, there were 40 patients (77%) with blunt trauma, the main cause of which was traffic accident. Twelve cases were included in Makiya's type 1, 7 in type 2, 11 in type 3, and 10 in central rupture. All patients with central rupture as well as a few patients with Makiya's type 1 and 2 were treated conservatively and all these recovered uneventfully. Twenty-four cases were treated surgically, including 10 hepatorrhaphy, 7 hepatic resection, 5 drainage only, and 2 untreatable. Twelve patients died within 4 days after surgery, 9 of which from bleeding (6 from the injured liver and 3 from. other organs), 2 multiple organ failure, and 1 brain contusion. Mortality for the patients sustaining Makiya's type 3 injury was 73% (8/11). Two more patients with most extensive hepatic injury died from massive bleeding without any effective management in the emergency center. There was also a death case due to myocardial infarction, in which necropsy revealed hepatic injury of unknown cause.
