Background- Liver is the most commonly injured organ in blunt abdominal trauma. The liver enzymes are often elevated in such cases and various cut off values are mentioned in literature. However the variation of liver enzymes among various grades of liver injury is not clear. The aim of our study is to find the variation of liver enzymes in various grades of liver injury and whether it affects any change in management including surgical intervention.

Method- Our study was a prospective observational study done between January 2023 to January 2024. All patients of blunt abdominal trauma found to have liver injury on contrast enhanced CT scan and managed conservatively were included. These patients were categorised according to American Association for the Surgery of Trauma (AAST) grading system. Various biochemical markers including liver enzymes are compared between the groups. Any change in management or need of intervention like percutaneous or surgical exploration was found out.

Results- A total of 35 patients were included. Most of the patients were in the age group of 31-40 (34.3%). Our study showed male preponderance (85.7%). Most patients presented to hospital within 24 hours of trauma (82.9%). Most had blood transfusion during their hospital stay (71.4%). AAST grade III injury was predominant (48.6%). Subgroup analysis between minor and major liver injury patients was done. Total bilirubin, direct bilirubin, SGOT, SGPT, ALP, total protein, serum albumin, haemoglobin, CRP, CRP/albumin ratio, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and INR evaluated serially and compared between the two groups. No significant difference was found between the two groups based on above biochemical parameters. No significant difference found in terms of need of intervention and overall change in management.

Conclusion- No significant difference in liver enzymes among the various grades of liver injury was found. Same is true for other biochemical parameters. So these parameters cannot be used to differentiate the various grades of liver injury. Further those patients who are managed conservatively do not need any intervention including surgical exploration. These patients can be managed conservatively with close monitoring and supportive treatment. However larger and randomized studies needed to validate the results.

Keywords: Liver trauma, Liver enzymes, grades of injury, Conservative management, Change in management