A 25-year-old patient undergoes road traffic injury. BP = 130/80 and pulse = 92/min good volume. Patient complains of upper abdominal pain. CECT is as shown as. The next line of management is?
Conservative
Exploratory laparotomy and packing
Exploratory laparotomy and hepatectomy
Exploratory laparotomy with hepatic artery ligation.
Ans. (a) Conservative.The following protocol for liver trauma is followed: Blunt abdominal trauma* Hemodynamic stability at admission or after two blood units transfusion* No signs of peritonitis | Abdominal US|| |Free intraperitioneal fluidNo free intraperitioneal fluid||Abdominal CTU/S* Only hepatic injury* Solid visceral injuries* Without hollow viscera sign of injury* Abdominal pain* Fracture of the lower ribs-Yes- | No |Reliable physical examination-No Observation | | Yes Hollow viscus injury is suspected? | | | No operative management-No Yes | | Operative management
Abdominal Radiography