Introduction

• Cause: common injury is blunt trauma, eg big dog/little dog syndrome, falls, gunshot wounds and road traffic accidents.
  In all cases of traumatic injury warn owner of potential complications at time of injury.
• Occasionally a fractured rib lacerates liver.
• Signs: concurrent injuries to other abdominal viscera; related to degree of hemorrhage: a few ml of blood loss to a massive exsanguination → shock.
• Diagnosis: radiography, ultrasonography.
• Treatment: fluid therapy, abdominal wrapping for shock; failure to improve the circulatory status will require surgical exploration of the peritoneal cavity.
• Prognosis: good if no complications.

Pathogenesis

Etiology

• Blunt trauma, eg falls from heights, road traffic accidents.
• Penetrating bite wounds from larger dogs.
• Gunshot wounds.

Pathophysiology

• Trauma to the rib cage → fractured rib → lacerate liver lobe → hemorrhage.
• Trauma → liver rupture → hemorrhage, massive ex-sanguination often associated with an avulsion of a hepatic lobe from the vena cava.
• Hepatic injury → ischaemia to a portion of the liver → devitalized tissue → bacterial proliferation → local peritonitis Peritonitis or liver abscess.
• May be other associated injuries, eg pancreatic, thoracic injuries etc Pancreas: trauma Thorax: trauma.

Timecourse

• Usually acute though may be several days with gall bladder injuries.

Diagnosis

Treatment

Outcomes