Because of its large size and particular location, the liver is probably the most commonly injured of all the intra-abdominal organs. This appears to be true for both penetrating and nonpenetrating trauma. In addition, during the past decade there has been an increase in those forms of trauma that are likely to result in more massive liver injury, as well as a greater involvement of associated organs.1,2 Specifically, the ice pick and knife have been replaced by the pistol and shotgun as weapons of violence, while in the same period injuries consequent to automobile accidents have become more common and have resulted from greater degrees of acute deceleration.
During the 22-year period from Jan 1, 1947, through Dec 1, 1968, 546 patients were admitted to Grady Memorial Hospital with some form of hepatic trauma (Table 1). Penetrating injuries accounted for 465 of these liver wounds, of which 271