Importance of serum transaminase levels in hepatic injuries

36 SUMMARY 134 patients whom were diagnosed liver injury between 1994-2004 at the Dicle University Faculty of Medicine were evaluated, retrospectively. 50 (37.3%) of them were involved as gun shot injury, of 48 (35.8%) were perforating trauma and of 36 (26.9%) were involved as blunt abdominal trauma. The causes of blunt abdominal trauma were intra vehicle accident at 25 patients, outside vehicle accident at 5 patients, fall from height at 3 patients and blow injury at 3 patients. Patients were assessed with serum transaminase levels by blood examinations for diagnosis and with CT and USG that haemodinamically stabilized ones. Suspicious intraabdominal bleeding cases were applied DPL. Injuries were classified and established as grade I at 31 (37.5%), grade II at 65 (48.5%), grade III at 27 (20.1%), grade IV at 7 (5.2%) and grade V at 4 (3%). 10 (7.5%) cases were treated by conservatively. The other patients were underwent a surgical procedure. 4 patients were died intraoperatively at the exploration stage and were couldn't done any definitive procedure. While patients having had concomitant injuries and isolated liver injury cases were assessed with their serum transaminase levels we noticed that existing concomitant injury was didn't have any statistically different effect on the transaminase levels (for AST; t, 368, p>0,05, for ALT; t, 1,146, p>0,05). Patients were classified according to their injury types, grade and existing concomitant trauma and enzyme levels were compared. At minor liver traumas (grade I and II) serum transaminase levels were determined as 156.3 IU for AST and 150,3 IU for ALT. However at major traumas (grade III, IV and V) these levels were determined as 294,2 IU for AST and 312,6 IU for ALT. The injury type and AST- ALT levels were compared by statistically. Altough we didn't find any difference at the perforating trauma and gun shot injury group, enzyme level difference between this group and the blunt abdominal trauma group was clear (for both two enzyme group p<0,001). While we compared the relationship between mortality and enzyme levels we found a meaningful relation with high enzyme levels and mortality (for AST; t 3.062, p<0,05, for ALT; t 3.321, p<0,05). We can be satisfied that serum transaminase levels as a cheap and simple investigation can be a guideline for trauma surgeons with other methods.