28. Prospective study of Management and Outcomes of Liver Trauma in Blunt Injury Abdomen Cases in Government Rajaji Hospital, Madurai

Modern day have seen a tremendous improvement in mans life style and comforts. But along with comforts, challenging threats to human health has also been emerging .The rapid increase in the number of motor vehicles resulted in very rapid increase in number of victims to blunt abdominal trauma. Motor vehicle accidents accounts for about 75 to 80% of the blunt abdominal trauma. The indian mortality rates for trauma are 20 times more than that of western countries. Blunt injury of abdomen is also a result from fall from height, assault with blunt objects, sport injuries, bomb blast. Due to the delay in diagnosis and inadequate treatment of liver injuries, most of the cases are becoming fatal. The knowledge in the management of blunt liver trauma has been increasing progressively.the morbidity and mortality remains at large. The reasons for this due to the time interval between the trauma and admission of the victim, inadequate and lack of appropriate surgical treatment, delay in the diagnosis, post operative complications. Liver involved in abdominal injuries vast majority of times. In case of patients with hemodynamic stability conservative management is the management of choice. With GRH, Madurai being tertiary care centre for south tamilnadu, the availability of blunt injury cases in adequate numbers, this study would serve to evaluate the modes of clinical presentations of blunt liver injury and signifying the precise management of various grades of liver injuries with its post operative morbidity and mortality. males are more common victims of Liver trauma in blunt injury abdomen as in stavros gourgiotis et al .low grade liver injuries accounts more than a high grade injuries as in stavros gourgiotis et al.low grade injuries favours the management towards non operative management most of the times ,Hepatorraphy accounts 42% and perihepatic packing accounts for 15%, Mortality rate in our study was 16 %. Most common age group involved is 41-50 years. Road traffic accident forms the most common mode of injury. So efforts should be made to bring road traffic regulations into strict action and traffic norms regulated. Measures should taken for early transport of the patients from the accident site to the trauma centres should be undertaken. Blunt injury abdomen is usually less obvious. Hence, repeated examination by multi specialty personnel in a specialized trauma care centre was required. X ray abdomen erect is a useful investigation to exclude associated hollow viscus injuries. CECT forms the core investigation of choice in dealing with Liver trauma in blunt injury abdomen patients, becomes more important investigation modality for grading of liver injury and to deciding operative and conservative management. Early diagnosis and repeated clinical examination and use of appropriate investigations are key for managing liver trauma in Blunt abdominal injuries