LIVER DISEASESM. Anil Kumar9th termLiver traumaRelatively uncommon Second most commonorgan injured in abdominal injuryOften associated with injuries to spleen and also to the pericardiumclassifcationdiagnosisHistory:a.istory of trauma to the!.lower anterior chest wall".upper abdomen

b. crushing injury to upper abdomen c .injuries to the ribs investigations#AS$% focused assessment sonography in trauma&ontrast enhanced &$ scan'iagnostic peritoneal lavageInitial management Penetrating inury:!. Assessment".Airway(.)reathing*. &irculation+. Relevant investigations, full blood count electrolytes-#$blood urea.s.creatinine)lood grouping and cross matching should be done/.v colloids for 0uid management)lood transfusionAssessment of clotting factors%$12/ntercostal drainage tube insertion!L"#$ I#%"RIES:o/nitial resuscitation%same as penetrating ijuriesoAssessment for hemodynamic stabilityo/f stable%&$ scan performed o$hen conservative management/ndications to stop the conservative management are, evidence of intra abdominal haemorrhageSurgical management/nitial step%gain of good access to the organRoo&to' incision (it) midline e3tension till 3iphisternum and retraction of costal margin-ateral transverse e3tension towards right gives good access to the liverStill bleeding persists%loo4 for hepatic artery lacerations and repair with567 proline8ortal vein injuries%repair with+67 proline