A bruised liver, also known as a hepatic contusion, is an internal injury where small blood vessels within the liver break and leak blood into surrounding tissues. This condition results from trauma to the abdominal area. Due to the liver’s vital functions and location, such an injury requires prompt medical attention.
Understanding a Bruised Liver
A bruised liver results from blunt force trauma to the abdomen, often occurring in motor vehicle accidents, falls, or direct blows during sports or physical altercations. The liver, situated in the upper right abdomen beneath the diaphragm and rib cage, is susceptible to such impacts due to its size and position.
Individuals with a bruised liver experience pain and tenderness in the upper right abdomen, sometimes radiating to the right chest, under the right ribs, or to the right shoulder. Other symptoms include nausea, vomiting, and abdominal swelling. In severe cases, signs of internal bleeding, such as dizziness, lightheadedness, pale skin, rapid heart rate, or decreased alertness, may develop.
Medical Treatment and Management
The medical approach to treating a bruised liver depends on the injury’s severity. Initial diagnostic steps involve imaging tests like computed tomography (CT) scans or ultrasonography to assess the damage and identify any internal bleeding. Blood tests also check for blood loss and liver enzyme levels.
Most liver bruises, particularly lower-grade injuries (Grade 1 or 2), can be managed without surgery. This conservative approach involves hospitalization for observation, strict bed rest, and intravenous (IV) fluids to maintain hydration and blood pressure. Pain medication, like acetaminophen, is also administered. For severe bleeding, minimally invasive procedures like angioembolization may be used, guiding a catheter to seal bleeding vessels. If bleeding is severe, persistent, or the patient is hemodynamically unstable, surgical intervention may be necessary to stop the hemorrhage, repair damaged vessels, or drain excess fluids.
Supporting Recovery at Home
Once discharged from medical care, supporting liver recovery at home requires adherence to medical guidance. Strict bed rest is recommended, typically for two to five days for less severe injuries, but potentially longer depending on the injury grade. Avoid strenuous activities, heavy lifting, or any impact to the abdomen for several weeks or months, as advised by the healthcare provider.
Dietary considerations also play a role; patients might not feel like eating regular foods immediately, but a balanced diet and adequate fluid intake are encouraged. Avoiding alcohol is advised, as the liver processes alcohol, and abstaining reduces strain on the healing organ. Certain non-prescription medications, such as NSAIDs (e.g., ibuprofen), should also be avoided unless specifically approved by a doctor, as they can affect liver function or increase bleeding risk.
When to Seek Immediate Medical Attention
Even after medical treatment and discharge, monitor for warning signs that could indicate a worsening condition or complications. Seek immediate medical attention if increasing or severe abdominal pain does not improve. Persistent nausea or vomiting, new or worsening abdominal swelling, or signs of shock (rapid heart rate, shallow breathing, dizziness, fainting, or confusion) also require urgent evaluation. A fever of 100.4°F (38°C) or higher, or the development of yellowish skin or eyes (jaundice), also warrants prompt medical consultation.