The liver is the most frequently injured abdominal organ, whether its injury occurs in isolation or in polytrauma. Liver injury can be open (penetrated) or closed (unpenetrated, contusioned).
The cause of occurrence
War conditions are much more inclined to create injuries, caused by a missile or explosive weapons (bombs, mines, grenades), while in peacetime, closed injuries are more common (car accidents, injuries in industry and agriculture, falls). In addition to these there are injuries and spontaneous rupture of the liver (primary liver tumors, malaria, toxemia of pregnancy, etc.).
The clinical picture
Manifestations of liver injury are pain in right upper quadrant that radiates to the right shoulder, palpable vulnerability of the region and the possible development of muscular defense. In cases of severe liver injury, the general condition of the patients will significantly be disrupted due to pronounced bleeding, which manifests signs of hemorrhagic shock (low blood pressure, decreased urine output, and the patient is extremely pale and exhausted).
It is based on anamnesis, clinical findings, objective examination, laboratory analysis, ultrasound, and CT (computer tomography).
The recent reports on the evolution of liver injury confirmed that approximately 20-30% of liver injuries, in adults, can be treated conservatively. Usually, it is used on patients who were hemodynamically stable, with no associated intra-abdominal injuries. These patients require continuous monitoring of vital signs and appropriate care and treatment with antibiotic support. In hemodynamically unstable patients, there is a suspicion associated with injuries to other abdominal organs, which requires urgent intervention.