We reviewed 87 @entity1 with @entity99 who were admitted to King Chulalongkorn Memorial Hospital, Bangkok, Thailand, from January 1995 to December 1999; 76% of them had sustained blunt @entity130 and 24% penetrating @entity130 . Their injury severity scores (ISS) ranged from 4 to 57 (mean 20.94+/-12.8); 50% of them were in shock on arrival; 8.1, 28.7, 25.3, 19.5, and 18.4% suffered from @entity99 graded I, II, III, IV, and V, respectively. Seventeen @entity1 (19.5%) were successfully managed non-operatively; three of them underwent hepatic angiography, which in two revealed leakage of contrast medium from the right hepatic artery; both were successfully treated by embolization. One @entity1 had bile leakage and collection, which was successfully treated by ultrasound-guided percutaneous drainage. Seventy @entity1 (80.5%) underwent exploratory laparotomy; nine of them died in the operating room. Of the remaining 61 who left the operating room alive, 21 had perihepatic packing, which was frequently used in those with injuries to segments V, VI, VII, and @entity797 (Couinaud's nomenclature). Eight @entity1 who had packing and one who had not died in the postoperative period. Two @entity1 who had packing underwent subsequent hepatic angiography with embolization before successful pack removal. The overall mortality was 20.7%. The mortality in complex @entity99 (grades IV and V) was 13 out of 33 (39.4%). We believe that non-operative management should be considered in haemodynamically stable @entity1 . Angiography with embolization is invaluable in improving outcome in both non-operative and operative @entity1 . Perihepatic packing is life-saving in complex @entity99 that cannot be effectively treated by simple surgical procedures. Finally, ultrasound- or CT-guided percutaneous drainage of bile leakage or collections spared a number of @entity1 from open and complicated surgery.

A multidisciplinary approach in the management of XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity99 :: ('MESH:D056486', 'Disease') :: ['hepatic injuries'] @entity797 :: ('1351', 'Gene') :: ['VIII'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity99 :: (MESH:D056486,Disease) :: ['hepatic injuries']
