[Management of liver trauma in adults: the results of selective nonoperative management and operative treatment].

The liver trauma is still one of the major injury in thoracoabdominal trauma, with increasing numbers and incidence in Taiwan. There is a trend toward a more conservative approach in the treatment of liver trauma. Nonoperative management for the stable patients with blunt liver trauma has been advocated in literature recently. In Veterans General Hospital-Taipei, forty-five patients with liver trauma have been admitted to Emergency Department after accident in past four years. Eighty-three percent of the trauma mechanism was blunt injury, and seventeen percent penetrating. There were ten patients selected as nonoperative management, and eight of them succeeded without operation. Retrospective analyzing various factors including age, trauma score, revised trauma score, injury severity score, amount of hemoperitoneum, blood loss and transfusion, morbidity and hospitalization, there are no statistic significances between nonoperative and operative groups, except that nonoperative group are less amount of blood transfusion. We suggest that the decision to treat the patient without laparotomy is not based on the degree of hemoperitoneum or the grade of liver injury, but rather on the stability of the patient. And further evaluation is needed.