Correlation of Computed Tomographic Findings in Blunt Liver Trauma with Treatments and Outcomes in Nakhonpathom Hospital

Abstract

Purpose: To correlate the grading of CT finding of blunt of liver injury in patients who received computed tomography (CT) imaging to their treatments and outcomes in Nakhonpathom hospital.

Design: Descriptive retrospective study.

Materials and Methods: From January to December 2010, one hundred and twenty-eight patients with blunt abdominal injuries who underwent contrast enhanced abdominal CT scan before their treatments were recruited and reviewed. Classifications according to the American Association for the Surgery of Trauma (AAST) were used. The CT gradings were correlated to the surgical findings and outcomes.

Results : 19 out of 128 patients who suffered a blunt abdominal injury had hepatic injury (14.84%). They were categorized into five grades : 12 patients, grade 1; 3 patients, grade 2; 3 patients, grade 3 and 1 patient, grade 5. There was no patient with grade 4 injury. Other organ injuries were also found such as fractures, splenic, kidney and intestinal injuries. Conservative treatment was given to 14 patients; 11 patients with grade 1, 2 patients with grade 2 and 1 patient with grade 3. Five patients underwent surgery; each with grade 1, 2, 5
and 2 with grade 3. One patient with grade 3 was died from ARDS.

Conclusion : Injury grading with CT may demonstrate the extension in blunt liver injury but it cannot determine the need of surgery