WOFAPS 2025 8th World Congress of Pediatric Surgery

Syed Waqas Ali ¹, Areej Salim ², Muhammad Arif Mateen ¹, Muhammad Sajjad Ashraf ¹

¹ Dow University Of Health Sciences Karachi Pakistan
² Aga Khan University Karachi Pakistan

Purpose To present our experience of multidisciplinary management of high-grade pediatric liver injuries.

Methods A retrospective review was undertaken for patients presenting with blunt liver injuries at two tertiary care centers in Karachi, Pakistan, from March 2021 to December 2022. Twenty-eight patients were identifed, and four patients fulflled the criteria for grade 4 and above blunt liver injury during this period.

Results One case with grade 4 liver injury developed hemobilia on 7th day of injury. He required two settings of angioembolization but had recurrent leak from pseudoaneurysm. He ultimately needed right hepatic artery ligation. Second patient presented with massive biliary peritonitis 2 days following injury. He was managed initially with tube laparostomy followed by ERCP and stent placement. The third patient developed large hemoperitoneum managed conservatively. One case with grade 5 injury expired during emergency surgery.

Conclusion Conservative management of advanced liver injuries can result in signifcant morbidity and mortality due to high risk of complications. Trauma surgeons need to have multidisciplinary team for management of these patients to gain optimal outcome.