Outcome and Efficacy of Non-Operative Management (NOM) in Traumatic Liver Injuries

Background: Liver traumas accounts for 5% of all emergency room admissions. Advancement in diagnostic &
interventional modalities led to obvious development in traumatic liver injury diagnosis & management.
The aim of this study: Is to analyze & evaluate outcome of non-operative management in 131 patients with blunt
traumatic liver injuries.
Patients and methods: This was a retro and prospective study to patients admitted to our department of
surgery, King Abdulaziz specialized hospital at Taif, Ministry of health, Saudi Arabia between December 2016 and
December 2021. Patients were divided into 2 groups: non-operative & operative.
Results: One hundred & thirty-one patients with blunt abdominal traumas: 97 (74%) patients managed by nonoperatively,
while 34 (26%) underwent surgery. Road traffic accidents were the main trauma cause. Grade III injuries
(43.5%) were the commonest. Biliary complications were the most frequent complications. Biliary complications,
such as leakage or strictures, were the most frequent complications that occurred in 39 (29.6%) patients & most
of these complicated biliary cases were managed conservatively by either US or CT guided drainage in 47 (36.8%)
patients [43 (32.8%) cases of the NOM group & 4 (3%) cases of the operative group] and/or ERCP with stenting in
33 (25.2%) patients [28 (21.4%) cases of the NOM group & 5 (3.8%) cases of the operative group]. The mortality
rate was 3%.
Conclusion: Non-operative management of liver trauma is highly efficient with high success rate even in highgrade
liver injuries.