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Subject Area

Obstetrics and Gynecology

Article Type

Original Study

Abstract

Objectives The aim of this study was to evaluate the management of patients with liver injury and the possible predictive factors for conservative treatment. Background Injuries are a major public health problem. The liver is the most commonly injured intra-abdominal organ. Conservative treatment thereby not only decreases the number of nontherapeutic laparotomies, but also achieves a reduction in morbidity and mortality. Patients and methods The present study was conducted on all patients with traumatic liver injury (20 patients) admitted to Menoufia University Hospital and El-Senbellawein General Hospital in the period between April 2015 and April 2016. Liver trauma was classified according to the Hepatic Injury Scale of the American Association for the Surgery of Trauma. To analyze the results, patients were divided into two groups – group A included patients with blunt trauma and group B included patients with penetrating trauma. According to the management plan, patients were further divided into group I (conservative treatment) and group II (operative treatment). Results Patients who were successfully managed conservatively had significantly higher mean systolic blood pressure (P = 0.004), lower mean pulse rate on admission (P = 0.003), and significantly lower American Association for the Surgery of Trauma grade of liver injury than patients who underwent operative management (P = 0.001). There was a significant difference in the number of blood unit transfusions between the types of management plan groups (P = 0.006). Conclusion Conservative management of traumatic liver injuries is safe when the decision is based on careful initial evaluation. During management, we identified possible predictive factors that may influence the management plan and outcome of patients with liver injury: pulse rate, systolic blood pressure at arrival to the hospital, the amount of blood transfused, and the grade of injury.

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