Chulalongkorn Medical Journal


Objective : This study is aimed to correlate the grading of blunt liver injury in patients who received computed tomography (CT) imaging to their treatments and outcomes at King Chulalongkorn Memorial Hospital (KCMH). Design : Descriptive study. Setting : Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital Materials and Methods : One hundred and thirty-five patients with blunt abdominal injuries who underwent contrast enhanced abdominal CT scan before their treatments were recruited for review. Classifications according to the American Association for the Surgery of Trauma (AAST) were used. The CT gradings was correlated to the surgical findings and outcome. Results : Eighteen out of 135 patients with hepatic injury (13.33%) who suffered a blunt abdominal injury were categorized into five grades: grade 1 in 2 patients were grade 1; 4 patients, grade 2; 8 patients, grade 4; and, 4 patients grade 5. There was no patient had grade 3 injury. Other organ injuries were also found such as fractures, splenic, kidney, and intestinal injuries. Conservative treatment was given to 11 patients; 2 patients with grade 1, 2 patients with grade 2, 5 patients with grade 4 and 2 patients with grade 5. Six patients underwent further intervention; 2 patients were grade 2,; 2 patients grade 4 and 2 patients grade 5. One patient was died from severe intracerebral hemorrhage. Conclusion : Injury grading with CT may demonstrate the extension of liver parenchymal damage but it cannot determine the need of surgery in patients.



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