Abstract:Objective: To evaluate the efficacy of nonsurgical management for blunt hepatic injury in adult patients.
Methods:The clinical records of 96 adult patients with blunt hepatic injury undergoing nonsurgical treatment at our hospital during the past 6 years were retrospectively analyzed. Of the patients, the hepatic injury grade was 51 (53.1%) in grade I, 30 (31.3%) grade II, 12 (12.5%) grade Ⅲ and 3 (3.1%) grade Ⅳ. Diagnosis was based on the history, ultrasonic examination, abdominal paracentesis and CT scan. All patients had monitoring of vital signs and were given symptomatic relief and supportive treatment.
Results:Nonsurgical management was successful in 87 patients (90.6%) and 9 patients were converted to operation. Complications occurred in 15 cases, which included 12 right pleural effusions and 3 perihepatic abscesses. All these complications resolved with non-surgical symptomatic treatment.
Conclusions:Nonsurgical management is feasible for adult patients with blunt hepatic injury. However, strictly defined indications and precise hemodynamic monitoring along with ultrasonic and CT examination are all critical factors for improving the success rate.