Radiologist and Surgeon in Managing Hepatic Trauma
Sarfraz Ahmed, M Qasim Butt, Ansar Latif, Tahir Iqbal Mirza, Ishtiaq Ahmad, Sdaad Ansar, Mustafa Talat
Aim: To assess the sensitivity and utility of sonographic findings in patients with hepatic trauma and to compare it with the operative findings and CT scan findings in the department of Radiology.
Study Design: A prospective clinical study.
Place & duration of study: The Department of Radiology and the Department of Surgery, Allama Iqbal Memorial Teaching hospital, Sialkot affiliated to Khawaja Muhammad Safdar Medical College, Sialkot from June 2016 to May 2020.
Methods: From June 2016 to May 2020; all patients serially presenting department of Radiology after admission to the surgical department of Allama Iqbal Memorial hospital with suspicion of hepatic injuries. The patients were classed in two groups: Group I- Patients who underwent surgery and Group II- Patients who were admitted and managed conservatively. A prospective cohort study in which the findings of all patients who underwent emergency sonograms were incorporated into data by the sonographer and physicians who interpreted them. All patients who sustained hepatic injuries during this period were identified.
Results: This study included 582 patients (73.4%), out of which 166 patients (28.5%) required surgical intervention and 416 patients (71.5%) were managed conservatively. CT scan was done in all patients of Group-11. Out of 166 operated patients, l I (6.63%) were categorized as Grade-1, 24(14.5%) in Grade-11, 88 (53%) in Grade-Ill, 36 (2l.7%) in Grade-IV and 7(0.4%) were categorized in Grade-V. Out of 416 non-operated patients, 30 l (72.4%) fell in Grade-I and 115(27.6%) in Grade-11. The correlation and comparison between sonographic data and operative findings in operated patients.
Conclusion: The most sensitive technique for detecting grade of liver injuries as a result of blunt abdominal trauma is ultrasonography. It is a primary diagnostic approach in such patients as it can be performed and repeated at bedside and aids in performing paracentesis.
Keywords: Abdominal trauma, ASST liver trauma grades, Computed Tomography, hematoma, hepatic trauma,