Liver is the largest solid organ in the body that is located under the rib cage on the right side of your abdomen. It performs many important functions in the body including production of bile, absorption and metabolism of nutrients, synthesis of various essential proteins and hormones and clearance of toxins from the body.
Liver injury occurs either through a blunt force like a kick on the abdomen or motor vehicle accident or through a penetrating injury like a stab/ gun shot on the abdomen. The injury causes a tear or cut of varying degree in the substance of the liver and this can cause enormous bleeding into the abdominal cavity.
Symptoms and signs of a liver injury
Immediately after an accident or stab you may experience
Severe pain in the abdomen
Swollen and firm abdomen
Dizziness due to low blood pressure
Bleeding from a penetrating wound
You will experience a rapid pulse rate
Fast shallow breathing
Cold clammy and pale skin
Diagnosis of a liver injury
Your doctor will subject you though various tests to detect liver injury
A thorough history regarding the mode of injury and a thorough physical examination
Serial blood test every few hours - to detect if there is continuing blood loss
CT scan abdomen - Will be done in most cases to diagnose liver injury and also to assess the extent of injury. CT scan can tell if there is continuous blood loss. It allows the radiologist to grade the extent of injury. Normally there are 6 grades of liver injury based on the severity of tear and blood loss. It can also pick up any other solid organ or intestinal injury.
In most of the situations, after an initial blood loss, the bleeding stops and the injury in the liver gradually heals by itself . The treatment consists of:
Strict bed rest
Blood transfusions to correct blood loss
Surgery – If there is evidence of continuous bleeding as seen by drop in blood hemoglobin.
Angiography – Here a procedure will be done to visualize the blood vessels that are bleeding and they can be sealed off to stop the blood loss.
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