Comparison of hepatic abscess after operative and nonoperative management of isolated blunt liver trauma

Hepatic abscess has been well recognized as a complication after blunt hepatic injuries. The clinical presentation of hepatic abscess after the operative and nonoperative management of isolated blunt liver injury is compared in this study. From 1995 to 2000, 674 patients with blunt liver injury were admitted and were managed either operatively or nonoperatively. Hepatic abscess occurred in 21 of these patients. Six of the 21 patients had their liver injuries managed nonoperatively (group 1) and the remaining 15 had their liver injuries managed operatively (group 2). The severity of injury of both groups of patients was similar, but group 2 patients required more blood transfusion and had a higher incidence of abscess formation. The formation of abscess occurred within 12 days after admission in the group 1 patients but ranged from 5 days to 6 years in the group 2 patients. One of the group 1 and eight of the group 2 patients had recurrent abscesses and required repeated admission. The nonoperative management of blunt hepatic trauma had a better outcome than the operative approach in terms of a significant decrease in abdominal infections and tended to result in complete recovery without the need of repeated admission and drainage.