This study is a prospective analysis of 61 patients who suffered penetrating hepatic trauma followed by surgery, and the aspects that influenced the post-surgical morbidity. The study was developed during 12 months at Hospital de Pronto Socorro de Porto Alegre, RS, Brazil, and did not consider the deaths which occurred along the first 24 hours after the trauma. The following aspects were studied: age, trauma mechanism, shock, hepatic lesion grade, associated intra-abdominal lesions, surgical technique and peri-hepatic drainage. We employed a multiple logistic regression model to evaluate the relationship between these events and the occurrence of post-surgical morbidity. The average age was 26:1: 3.49, varying from 17 to 63 years. Gunshot wounds occurred in 34 cases (55.7%) and stab wound in 27 cases (44.3%). Shock was present in 37 cases (60.7%). Grade I and II hepatic lesions (42.6% and 41% respectively) were the most frequent while the most commonly associated intra-abdominal lesions were those of stomach (18 cases/29.5%) and colon (9 cases/14.7%). The average ATI was 20.5 ± 17. Pneumonia (10 cases/25%) and intra-abdominal abscess (6 cases/9,8%) were the most frequent post-surgical complications. The series presented two deaths. Shock, gunshot wounds and the complexity of the surgical procedure were considered to be predictive factors of morbidity.
Hepatic trauma; Abdominal trauma index; Abdominal abscess