The secondary management of complicated liver injuries.

A retrospective review of the management of 15 patients suffering from the complications of blunt hepatic trauma is presented. All but one were referred after receiving primary surgical care elsewhere. Seven of them were wrongly thought to have sustained a relatively minor degree of injury. Selective arteriography and grey-scale ultrasonography were of value in the localisation of intrahepatic filling defects. The presence of jaundice correlated closely with persisting sepsis. Biliary fistulas closed spontaneously in all cases.