Resumo

ENRIQUEZ-DOMINGUEZ, Lenin; CASTILLO-MORENO, José Romeo; HERRERA-RAMIREZ, Fernando  e  DIAZ-ROSALES, Juan de Dios. Hepatic trauma due to stab and gunshot wounds: Our experience in Ciudad Juárez, México. Cir. gen [online]. 2011, vol.33, n.1, pp.21-25. ISSN 1405-0099.

Objective: To analyze the management of liver injuries due to penetrating trauma in a trauma hospital without computed tomography. Design: Cohort, non randomized analytical comparative study. Setting: General Hospital of Ciudad Juárez, Mexico (second level health care center). Statistical analysis: Percentages as summary measure of qualitative variables, Pearson's χ² test and Fisher's exact test. Patients and methods: Patients subjected to surgery due to abdominal penetrating trauma with liver injury Group I (stab wounds) and Group II (gunshot wounds). We studied the following dependent variables: age, gender, injury mechanism, hemodynamic state, hemoperitoneum, degree of injury, concomitant injuries, treatment, complications, and mortality. Results: We included 86 patients with liver injury; 70% of laparaotomies were therapeutic, 17% were damage control surgeries, and 13% were non-therapeutic. The most common injury degrees were I and III. The established treatment was ''conservative-surgical'' in 44%, hepatorrhaphy in 33%, and packing in 23%. Intraabdominal concomitant injuries occurred in 70% The most frequent complication was hypovolemic shock. Mortality was of 4% for Group I and of 32% for Group II patients. Discussion: There was no significant difference between both groups and among the studied variables, except for mortality, which was higher in the gunshot group of patients. Management according to the algorithms of level I trauma centers cannot be followed at our hospital.

Palavras-chave : Liver/injuries; wounds; penetrating/therapy; wounds, gunshot; wounds, stab; tomography; X-ray; computed.

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