Chulalongkorn Medical Journal


Objective : This study is aimed to correlate the grading of blunt liver injuryin patients who received computed tomography (CT) imagingto their treatments and outcomes at King Chulalongkorn MemorialHospital (KCMH).Design : Descriptive study.Setting : Department of Radiology, Faculty of Medicine, ChulalongkornUniversity, King Chulalongkorn Memorial HospitalMaterials and Methods : One hundred and thirty-five patients with blunt abdominalinjuries who underwent contrast enhanced abdominal CT scanbefore their treatments were recruited for review. Classificationsaccording to the American Association for the Surgery of Trauma(AAST) were used. The CT gradings was correlated to thesurgical findings and outcome.Results : Eighteen out of 135 patients with hepatic injury (13.33%) whosuffered a blunt abdominal injury were categorized into fivegrades: grade 1 in 2 patients were grade 1; 4 patients, grade 2;8 patients, grade 4; and, 4 patients grade 5. There was nopatient had grade 3 injury. Other organ injuries were also foundsuch as fractures, splenic, kidney, and intestinal injuries.Conservative treatment was given to 11 patients; 2 patients withgrade 1, 2 patients with grade 2, 5 patients with grade 4 and2 patients with grade 5. Six patients underwent furtherintervention; 2 patients were grade 2,; 2 patients grade 4 and2 patients grade 5. One patient was died from severeintracerebral hemorrhage.Conclusion : Injury grading with CT may demonstrate the extension of liverparenchymal damage but it cannot determine the need ofsurgery in patients.


Faculty of Medicine, Chulalongkorn University

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