In contrast to non-surgical treatment of blunt liver trauma, non-operative management of liver gunshot injuries is not widely accepted.
Dr Omoshoro-Jones and colleagues conducted a prospective study to evaluate the experience of non-operative management of gunshot wounds to the liver.
All patients presenting with liver gunshot injuries who were hemodynamically stable with no evidence of peritonism underwent a protocol of non-operative management.
The investigators enrolled 33 patients with a mean age of 25 over a 36-month period.
The investigative team found that 14 had grade III injuries according to the American Association for the Surgery of Trauma classification.
|Non-operative management was successful in 31 of 33 patients|
|British Journal of Surgery|
The team noted that 11 patients sustained major, or grade IV/V injuries, while 8 sustained minor, or grade I/II injuries.
Non-operative management was successful in 31 of 33 patients.
The team observed that 2 patients required delayed laparotomy for indications unrelated to the hepatic trauma.
The investigators reported that 1 patient died from necrotizing fasciitis, which appeared unrelated to the liver injury.
Dr Omoshoro-Jones' team concludes, “This study demonstrated that, regardless of the grade of liver trauma, non-operative management is safe and effective in appropriately selected patients with liver gunshot injuries treated in centers with suitable facilities.”