Liver laceration is not an unusual injury. Because of the liver's size and its fixed position in the body, it is prone to injury. It is the second most commonly injured organ when the abdomen is injured. When the liver is injured, it can be lacerated and this can be life threatening.
Types of Liver Laceration
The two causes of liver laceration are blunt trauma and penetrating trauma. Blunt trauma laceration occurs generally when ribs that cover the liver (7 to 9) are fractured. This is the most-common cause, which generally happens as injury received in a motor vehicle accident. Penetrating trauma is when something outside the body, say a knife, enters the body and cuts the liver. Each injury is also graded on a scale that rates the injury anywhere from 1 to 6 with 6 being the most severe.
Surgery or Not
If the liver has been lacerated, there will be bleeding. The abdominal area will be painful or at least tender. The patient may even have pains in the right shoulder and signs of shock. Surgery used to be used to repair all lacerations until studies found that 86 percent of them had stopped bleeding by the time the surgery was done. This meant the body had already begun recovering from the laceration on its own and the surgery simply created one more injury for the body. Nowadays, the diagnosis of a lacerated liver is made by a CT scan. This is non-invasive and indicates whether the bleeding has stopped or not.
Common Treatment for Lacerations
Large lacerations will still require a laparotomy (surgery that opens the abdomen) and repair. Smaller lacerations can be monitored to ensure the body is able to repair itself. Initially, the doctor will monitor the patient to see if the bleeding stops. Blood tests will be done to measure the hemoglobin and hematocrit in the blood. After an initial drop after the injury, the numbers should begin to increase. Patients will also need total bed rest for two days. During this time, additional blood testing will be done every 6 to 12 hours to ensure no reverses in the hemoglobin or hematocrit. After being discharged from the hospital, strenuous physical activity may be limited for up to three months as the liver recovers from the injury.
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