A prospective study of 15 consecutive patients admitted with high velocity missile liver injuries of the liver was done at Lacor hospital between November 1996 and May 1997. Operative findings, treatment offered and factors influencing morbidity and mortality were noted. All patients were followed up for two months postoperatively.
Fourteen patients sustained gun shot wounds while one was injured by a bomb blast fragment. Ages ranged from 2 to 33 years (mean 24.4 years). Two patients sustained liver injury alone while the rest had other associated visceral injuries as well. Grade I, II and III liver injuries were seen in 7, 5 and 2 patients respectively. One patient had a bullet perforation of the liver and could not be classified on this scale. Six patients received blood transfusion.
Four patients (27%) developed complications. One had a sub-hepatic abscess while the other three had wound infections. Two patients died, one of exsanguination and the other of septic shock.
High velocity missile injuries of the liver are associated with high transfusion needs and morbidity both of which can be minimized by a policy of conservative surgery.
