Injuries to the liver: analysis of 20 cases.

Twenty cases of liver injury among 55 consecutive cases of abdominal injury submitted to laparotomy over a four-year period are reported. Forty-four of the cases were blunt injuries, and the cases of liver injury were in this group. Road traffic accidents accounted for 37 of the 44 cases and 17 of the 20 liver injuries. Except in two cases injury to the liver was associated with injury to other organs. Severe chest injury was found in 40% of the cases and serious skeletal injury in 45%. The overall mortality in blunt injury to the liver was 20% (4 cases) and was directly attributable to the liver injury in only one case.Liver injuries are classified as minor or major according to the depth of the wound and the associated destruction of liver tissue. Liver resection is advocated for major injuries. Right hepatic lobectomy was performed on five occasions and three of the patients survived. Death in the other two was due to associated injuries. The remarkable regenerative capacity of the liver is emphasized.