OBJETIVO: analisar características epidemiológicas relacionadas ao trauma hepático e fazer breve revisão das modalidades diagnósticas e de tratamento. MÉTODO: estudo retrospectivo de fevereiro/2002 a maio/2007 através de prontuários de 154 pacientes admitidos com trauma hepático no Hospital Universitário Cajuru (HUC). RESULTADOS: Foram encontrados 90,26% das vítimas de trauma hepático do sexo masculino e a média de idade de 26,28 anos. Quanto ao mecanismo de trauma, 72,73% foram por trauma penetrante, sendo que destes, 55,84% foram por arma de fogo e 16,88% por arma branca; e 27,27% por trauma contuso, no qual 73,81% envolveram colisões por veículos automotores e 26,49% outros. Na admissão o período de 0h - 12h foi o de maior prevalência, a média da pressão arterial foi de 117,6/72,3 mmHg, da freqüência cardíaca de 99,03 bpm e do Glasgow de 13,6. O tempo decorrido entre a admissão e a realização da primeira cirurgia foi de menos de 2 horas em 60,43%. Verificou-se maior incidência da lesão Grau II, seguida da Grau III e IV (totalizando 88,3%). As lesões cirúrgicas associadas foram encontradas em mais de 75% dos casos. O ISS médio foi de 15,09, 19,85, 27,83, 35,47 e 40,93 e a sobrevida de 100%, 88,88%, 81,25%, 48,48% e 22,23% nas lesões grau I, II, III, IV e V, respectivamente. CONCLUSÃO: os dados epidemiológicos encontrados neste estudo refletem a violência na sociedade moderna, que se traduz com aumento da complexidade das lesões encontradas e constitui desafio para decisão da melhor conduta terapêutica.
BACKGROUND: We analyze the epidemiological characteristics related to hepatic trauma, and we do a brief review of the different types in diagnosis and management. METHODS: A retrospective study from February 2002 to March 2007. One hundred fifty four patients were admitted at Cajuru University Hospital with hepatic trauma. RESULTS: We found that 90.26% of hepatic trauma victims were male with average age of 26.28 years old. Hepatic no blunt traumas were 72.73%. Among these, 55.54% were firearm traumas and 16.88% were caused by stab wounds. Blunt traumas were responsible by automobile collisions in 73.81%, and 26.49% were by other mechanisms. Most patients arrived at the hospital between 12:00 A.M. to 12:00 P.M. The average blood pressure was 117.6/72.3 mmHg, the average cardiac frequency was 99.03bpm and the Glasgow average was 13.6. In 60.43% of the cases, the time gap between admission and surgery took less than 2 hours. The most frequent lesions were related to a second degree followed by 3rd and 4th degree lesions reaching 88.3% of the cases. Associated lesions treated surgically were found in more than 75% of the cases. The average ISS was 15.09, 19.85, 27.83, 35.47, and 40.93%. The survival rate was 100, 88.88, 81.85, 48.88, and 22.23% in 1st, 2nd, 3rd, 4th, and 5th degree lesions, respectively. CONCLUSION: The epidemiological data reflect modern society violence, which is translated by the increasing complexity in lesions found, and it has been a challenge for the surgeon to choose the best therapeutic method.