Hepatic Injuries

      Injury to the liver range from controlled subcapsular hematoma and laceration of the parenchyma to severe 

      vascular injury of the hepatic veins.

      The friability of liver tissue ,the extensive blood supply ,and the blood storage capacity cause hepatic injury to

       result in profuse hemorrhage. 

       The trend in blunt hepatic trauma is nonoperative management of the hemodynamically stable patient.

The traditional treatment of liver trauma was exploration and surgical packing but the nontherapeutic

 laparotomy rate was as high as 67%, largely because most liver injury hemorrhage resolves 

spontaneously before laparotomy can be performed.

SIGNS AND SYMPTOMS:

    Upper right quadrant pain

Abdominal wall muscle rigidity, spasm. or involuntary guarding

Rebound tenderness

Hypoactive or absent bowel sounds

Signs of hemorrhage and/or hypovolemic shock