Major Trauma
The following information provided is to help your recovery following abdominal trauma. This leaflet contains advice on how to manage your injury when you are discharged.
What will be arranged prior to going home?
- Tablets to take home
- GP letter
- Outpatients’ appointment
- Fit note – formally know as a sick note (if required)
Support services (if required. Not for cleaning or shopping)
The abdomen can be injured by many types of trauma. Trauma can be caused by:
- A direct blow
- Impact with an object
- Sudden deceleration – Road traffic accident, fall from a height
The severity of abdominal injuries varies depending on how the injury happened. Some injuries to the abdomen are minor and can be managed by observation. More serious injuries may require an operation.
The liver
The liver is the largest solid organ in the body and is necessary for survival. The liver has many jobs:
- It makes bile which helps with digestion
- It filters and cleans the blood and helps remove bacteria
- It stores carbohydrates, vitamins, and minerals
- It makes proteins, glucose, and clotting factors
It breaks down hormones and certain drugs
Management of a liver injury
Non operative management: Involves a conservative approach by clinical observation this involves admission to hospital and close monitoring of your vital signs including blood pressure, heart rate, and regular bloods tests to look for signs of bleeding and other complications relating to your injury.
Embolisation: The procedure is carried out in interventional radiology and is less invasive than an operation. The liver is accessed via a blood vessel in your groin, further bleeding is reduced by preventing blood flow from reaching damaged parts of the organ.
Recovery
It will take time for your liver to completely heal after an injury, whilst you are recovering from your injury, your liver is at risk of being damaged further. You will not be able to attend work whilst recovering and you will need to stop driving for at least 4 to 6 weeks.
Most liver injuries described as a low-grade injury will heal in approximately 6 to 8 weeks. A more severe liver injury can take four to six months to heal. During this time, you should avoid certain high-impact activities such as:
- Heavy lifting
- Contact sports
- Biking
- Any activity where falls are a risk, for example Skiing, climbing or DIY at a height
- Diving
- Rigorous sexual intercourse
Post discharge
Some symptoms can be normal following an injury to the liver. You may experience some of the following symptoms over the first few days and weeks:
- Mild abdominal pain
- Mild pain in your right shoulder or above the right collar bone
- Intermittent nausea
- Mild abdominal distention (swelling)
- Mild elevation of body temperature
- Some discomfort around the bellybutton or the right side of abdomen
Important
If symptoms are constant or if they are increasing, you should seek medical advice from:-
- Your GP
- Major trauma coordinators
- Nursing staff on the major trauma ward
- You can also contact the secretary of your surgical consultant
When to return to hospital
We know most people recover well from an injury to the liver and do not experience complications, however if you experience the following symptoms, please return to your local Emergency Department:
- Increased abdominal pain or new abdominal pain
- Dizziness
- A rapid heart rate
- Vomiting
- Collapse
- Fever, rigors, shivering – this may be signs of infection
The following are a list of possible complications of non-operative management of injury to the liver. (The risk of complications increase for the elderly, overweight patients, or for patients with pre-existing medical conditions):
- Recurrent bleeding
- Collection of blood
- Collection of bile
- Jaundice
- Abscess
- Fluid collection within the chest
- Chest infection
- Blood clot in the veins of the legs or lungs
It is important not to miss any of your follow up appointments. A follow up CT scan may be necessary.
Medication
Before you leave hospital, you will receive a supply of the tablets which you will need to continue to take at home. The nurse will explain the side effects which you need to be made aware of and when it is suitable for you to take.
There is a label on your medicine box that tells you how and when to take it. Please read these instructions carefully before taking your medicine. There are some medicines that have special instructions, such as whether to take them before or after food. These instructions will also be on the label.
It is important to ONLY take the medications prescribed to you when you are discharged from the hospital.
Exercise
This will be discussed with you by a physiotherapist before you leave the hospital. Please refer to your physiotherapy booklet which provides a guide to an exercise program.
Sleep, rest and relaxation
You will experience feeling weak and become tired more quickly following your trauma. Take care to build things up gradually with plenty of sleep, including an afternoon nap if needed.
- Try to get a balance between activity and rest.
- You may need to limit the number of visitors you have when you first go home.
- Your sleep pattern may be disturbed, this is unpleasant but should disappear within the first few weeks
Emotions
Do not worry if you feel upset or emotional – this is a normal reaction. Symptoms of mood swings, including depression, fear, anxiety, loneliness, helplessness, and anger, may occur for the first few weeks following a Major trauma.
Contact us
In a medical emergency you should contact 999
If you believe your condition is serious then please return to your local emergency department, bringing all discharge documentation you have been given.
For information and advice on your discharge and recovery please contact Ward 36 to speak with the nursing staff.
- Major Trauma coordinators at The James Cook University Hospital
Telephone: 01642 854226, Extension: 55918 - Ward 36: Telephone: 01642 854536 (Available 24 hours a day)
- Major Trauma coordinators: Telephone 07442 790 011
Email: [email protected]
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.
T: 01642 835964
E: [email protected]