Evaluation of Patients with Liver Injuries Treated by Perihepatic Gauze Packing

Abstract

Background: The liver is one of the most common organs
injured after blunt abdominal trauma. The control of severe
hemorrhage remains a problem.
Methods: One-hundred thirty-eight patients diagnosed as
liver injury between 09/2003 and 08/2006 had been evaluated
prospectively in Al- Kindy Teaching Hospital.
A distinction was made between hemodynamically stable and
unstable patients. Different modalities of surgical procedures
were done concentrating on perihepatic gauze packing.
Results: (60 out of 138) patients included in the study were
clinically evaluated as hemodynamically stable. The average
abbreviated injury severity score (ISS) was 25. Twenty
patients underwent abdominal surgery. In 12 of them
additional liver treatment was performed. The mortality was
three, all were non-liver related.
Seventy eight patients were considered to be
hemodynamically unstable, and had an average ISS of 38. All
of them needed abdominal surgery.
Gauze packing was used as initial therapy for bleeding
control from injured liver in 34 patients of both
hemodynamically stable and unstable groups with a mortality
of 11 patients (32.7%).
Conclusion: perihepatic gauze packing is considered as a life
saving and a quick method for controlling ongoing
hemorrhage in the treatment of liver injuries before
undertaking definitive repair under controlled conditions