Conservative treatment of hepatic trauma

: Liver trauma has increased over the past few years. In haemodynamically stable patients with hepatic injuries a conservative approach is possible, mainly as a result of the reliability of the diagnostic tools available which allow accurate monitoring of the patients. Computed tomography (CT) of the abdomen is extremely useful for documenting the extent of the damage. Of 16 patients treated for blunt hepatic injury, 10 were managed non-operatively. In this group of patients there were no deaths or delayed laparotomies. Total hospital stay and transfusion requirements were lower. The advantages of non-operative therapy include a lower incidence of abdominal septic complications. All patients managed non-operatively were monitored until their CT scans showed complete resolution. The authors conclude that non-operative management of hepatic injury is a safe technique applicable to haemodynamically stable patients.