Liver Trauma

Definition

Liver trauma refers to any injury sustained by the liver, which can range from minor bruises to severe lacerations and fractures.

Types

Blunt Liver Trauma

• Blunt trauma occurs due to non-penetrating forces, such as:
  • Motor vehicle accidents
  • Falls from heights
  • Sports injuries
  • Child abuse
• Blunt liver trauma can cause:
  • Hematoma
  • Laceration
  • Rupture

Penetrating Liver Trauma

• Penetrating trauma occurs due to penetrating forces, such as:
  • Gunshot wounds
  • Stab wounds
  • Sharp objects
• Penetrating liver trauma can cause:
  • Hemorrhage
  • Laceration
  • Rupture

Causes

• Blunt liver trauma:
  • Motor vehicle accidents → deceleration forces → liver injury
  • Falls from heights → landing on the abdomen → liver injury
  • Sports injuries → direct blow to the abdomen → liver injury
  • Child abuse → physical abuse → liver injury
• Penetrating liver trauma:
  • Gunshot wounds → bullet penetration → liver injury
  • Stab wounds → sharp object penetration → liver injury
  • Sharp objects → direct penetration → liver injury

Clinical Features

• Abdominal pain
• Abdominal tenderness
• Abdominal guarding (muscle tension)
• Abdominal distension
• Nausea and vomiting
• Loss of consciousness (in severe cases)

Investigations

FAST (Focused Assessment with Sonography for Trauma)

• FAST is a bedside ultrasound examination
• FAST can detect:
  • Free fluid in the abdomen
  • Liver injury
  • Spleen injury
  • Intestinal injury

CT Scan

• CT scan is a more detailed imaging study
• CT scan can detect:
  • Liver laceration
  • Liver hematoma
  • Liver rupture
  • Other abdominal injuries

Angiography

• Angiography is an imaging study that uses X-rays and contrast dye
• Angiography can detect:
  • Arterial bleeding
  • Venous bleeding
  • Other vascular injuries

Complications

• Hemorrhage
• Infection
• Liver failure
• Abdominal compartment syndrome
• Multiple organ failure

Management

Non-Operative Management

• Stable patients with minor liver injuries can be managed non-operatively
• Non-operative management includes:
  • Pain management
  • Fluid resuscitation
  • Observation

Operative Management

• Unstable patients or those with severe liver injuries require operative management
• Operative management includes:
  • Laparotomy
  • Liver repair
  • Hemostasis

Treatment

• Treatment depends on the severity of the liver injury
• Treatment options include:
  • Observation
  • Non-operative management
  • Operative management

Homoeopathic Medicines

• Arnica montana: for liver trauma and hemorrhage
• Belladonna: for liver trauma and inflammation
• Chamomilla: for liver trauma and anxiety
• Hypericum: for nerve damage and pain
• Ruta graveolens: for liver trauma and scar tissue