The problems of closed liver injuries.

Because laceration of the liver is a condition which the surgeon is rarely called upon to treat, 36 cases of liver injury admitted between 1926 and 1958 have been reviewed and the results compared with those of other authors. As well as discussing the incidence of this injury and its relation to age, sex, and pathology, the surgical management is outlined. The greatest single factor which has assisted the surgeon is transfusion of whole blood. Early operation is considered advisable, and suturing is preferred in repairing damage to the liver substance and achieving haemostasis. Nevertheless, the mortality rate is high, in this series 60%, which compares favourably with that of other series. It is notable that patients operated on have a better chance of survival than those not operated upon.