The Australian and New Zealand journal of surgery
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A retrospective review of 102 cases of hepatic trauma in the Auckland area between 1979 and 1985 is presented. Particular attention has been focused on those cases where there was massive bleeding, and the prognostic factors that govern outcome have been determined. Mechanism and multiplicity of injury, and the presence of severe hypotension (systolic blood pressure less than .80 mmHg) either at presentation or following induction of anaesthesia were the four most important determinants of prognosis. ⋯ It is concluded that the mortality of liver injury from blunt trauma far exceeds that of penetrating trauma, and that severe hypotension at the time of presentation indicates a poor prognosis. A good outcome is possible in those patients who have a significant disruption of the liver architecture of one lobe following resection of devitalized tissue. Caval or retrohepatic venous-type injuries carry a grave prognosis.