THIS communication presents two cases of intrahepatic hematoma from blunt abdominal trauma that were treated with contrasting methods. It shows that more aggressive therapy using early hepatic lobectomy can be used to prevent the delayed complications of intrahepatic hematoma.
With the increase in high speed automobile accidents, blunt thoracico-abdominal trauma has resulted in a high incidence of hepatic trauma. The steering wheel is the usual cause of injury resulting in a variety of types of trauma to the liver. Lacerations of the liver are common and their management has been well described by multiple authors. Depending on the degree of injury, operative management consists of drainage, suture repair of the laceration, or hepatic lobectomy. A less common result of blunt liver injury is intrahepatic hematoma. Conservative management of this type of lesion has frequently resulted in less than satisfactory results. Prior to the last few years, many surgeons have recommended
Richardson RE, Gumbert JL, Gale SA. Traumatic Intrahepatic HematomaAn Indication for Hepatic Lobectomy. Arch Surg. 1967;95(6):940-943. doi:10.1001/archsurg.1967.01330180088015