Trauma management in a tertiary care hospital in Peshawar, Pakistan

With an increasing incidence of road traffic accidents and weapon injuries there is increasing need for improvement in trauma management. Liver being a highly vascular organ and strategically located is difficult to manage. Study was conducted in Surgical 'A' Unit, Lady Reading Hospital, Peshawar from August 2003 to September 2005. It was a descriptive study and all patients were operated in emergency department. All relevant data of patients were recorded from the emergency and admission protocols. A total of 364 trauma patients were received and among those 48 patients had liver trauma, 75% of patients had penetrating and 25% had blunt trauma. Most of the patients had grade III liver injuries. There were no grade V and VI injury. Repair with perihepatic packing for liver injuries remains the most frequently performed procedure (41% of patients). In a stable patient blunt trauma liver can be managed conservatively by serial examinations and investigations with emergency laparotomy facilities at hand. Perihepatic packing and damage control surgery is the valuable procedure at hand. Increasing grades of liver injuries leads to increasing morbidity and mortality. The same is the case with multiple organ injuries.