Shock and being hit in the liver

I

irish52084

New member
In another thread, I just saw a reference to temporary wound cavity and a small argument on whether it actually did any real damage. Then I had a thought: I've been kicked in the liver before, and the mere force of the shock to the liver put me down immediately. It's almost like an unexpected shut down of your PC, it just cold stops you in your tracks and you fold for a bit. All it takes is a bit of force, or shock to the right area to make it happen.

Maybe temporary cavity and it's stretching/shock effect can actually be a factor in the effectiveness of a handgun caliber. Just a random thought that popped in my head and I felt the need to throw it out there for debate.
 
I am not a surgeon, but I did do a 3 month surgery rotation as a 3rd year medical student. The problem with the "temporary" wound channel is that it can disrupt blood vessels and leave devitalized tissues that MUST be removed to prevent overwhelming infections. The temporary wound channel is often the cause of death especially with high velocity wounds.

Being shot in the liver is lethal in many instances because of the huge volume of blood coursing through the liver. In addition, since many of the blood clotting factors are made in the liver, you run into secondary bleeding problems if it is severely injured. Not a pretty wound at all.
 
Haven't seen the other thread, but here are a few passages taken directly from Vincent DiMaio's textbook, Gunshot Wounds: Practical Aspects of Firearms, Ballistics, and Forensic Techniques:

"In the case of handgun bullets, the bullet produces a direct path of destruction with very little lateral extension within the surrounding tissues,
i.e., only a small temporary cavity is produced. As a general rule, the temporary cavity plays little or no role in the extent of wounding. To cause significant injuries to a structure, a handgun bullet must strike that structure directly. The amount of kinetic energy lost in the tissue by the bullet is insufficient to cause the remote injuries produced by a high-velocity rifle bullet."

"The size of both the temporary and the permanent cavities is determined
not only by the amount of kinetic energy deposited in the tissue but also by
the density and elastic cohesiveness of the tissue. Because liver and muscle have similar densities (1.01 to 1.02 and 1.02 to 1.04), both tissues absorb the same amount of kinetic energy per centimeter of tissue traversed by a bullet. Muscle, however, has an elastic, cohesive structure; the liver, a weak, less cohesive structure. Thus, both the temporary and the permanent cavities produced in the liver are larger than those in the muscle. In muscle, except for the bullet path, the tissue displaced by the temporary cavity returns to its original position. Only a small rim of cellular destruction surrounds the permanent track. In liver struck by high-velocity bullets, however, the undulation of the temporary cavity loosens the hepatocytes from the cellular supporting tissue and produces a permanent cavity approximately the size of the temporary cavity. Lung, with a very low density (specific gravity of 0.4 to 0.5) and high degree of elasticity, is relatively resistant to the effects of temporary cavity formation, and has only a very small temporary cavity formed with very little tissue destruction."
 
If your liver is anything like a deer's liver, you're going to DIE. Of course this is based on observations of hits by a rifle round. Most of the deer hit with .25+cal bullets died within a few seconds-most on the spot.
"Kicked in the liver"??? Maybe kicked in the lower back near the liver. Pretty sure a kick hard enough to affect your liver will also have an effect on the spine causing some loss of function of the lower limbs.
 
Yeah, I'm having a hard time with "kicked in the liver" as well.
Liver.jpg

Maybe it was the kidney?
 
The kidneys are also protected by the ribs. They are quite a bit higher than is often thought.

While the temporary stretch cavity caused by handguns rounds is certainly less severe and therefore less debilitating than that caused by a high velocity rifle round, it does exist.To think that is has no effect due to it's relatively smaller area is silly.
 
Many people have easily palpable livers a doctor can feel on examination. An upward kick below the right costal margin, (right front side of rib cage) will impact the liver directly. Not sure if that is what he is referring to, but yes, very possible to get "kicked in the liver."
 
A kick carries a lot of force. Bench pressing 250 pounds is impressive, but leg pressing 400 is not. The impact may not be direct to the liver, but significant force can be delivered.
 
Perhaps I am wrong, but I think the information quoted by Friar Whently is old and based on low velocity handgun bullets, either solid lead or full metal jacket. It does not seem to take into account modern high velocity bullets or calibers like the .357 Magnum or .44 Magnum, let alone 5.7, .454 Casull, and the like.

Regardless, my non-medical opinion is that a person shot in the liver or kidney is going to be in a world of hurt. A person stabbed in the kidney and who was fortunate enough to survive, described the sensation as the most awful pain he had ever experienced and said he was totally disabled and lost consciousness in a few seconds. Doesn't sound like he was ready to draw his sixgun and shoot it out with the bad guy.

Jim
 
Dr. Martin Fackler noted that while many of the body's tissues, muscle in particular, are elastic enough not to be permanently damaged by the temporary cavitation produced by most handgun bullets, there are exceptions and the liver is one that he specifically enumerated as an inelastic tisse that can be damaged by handgun-level temporary cavitation.

Also, a high-energy bullet that fragments within the liver would be more damaging still. Dr. Fackler noted that fragmenting centerfire rifle bullets often display a synergistic effect between the secondary wound channels cause by bullet fragments and the temporary cavity to produce a permanent cavity much larger than the expanded diameter of the bullet itself even in elastic tissues like muscle. The problem with fragmenting handgun bullets is that most of them do it too rapidly to achieve adequate penetration and effect the vital organs. However, this is not universally true as some semi-jacketed hollowpoint bullets such as the famous 125gr .357 Magnum loadings shed their jackets in larger shards relatively deep in their penetration trac (usually around 6-8 inches) and retain a heavy enough core to still penetrate adequately (the 125gr .357 Magnum SJHP's typically penetrate 11-13"). Such fragmentation, penetration, and energy in a non-elastic tissue like the liver would most likely cause a very gruesome wound that would very likely be fatal.
 
Mobuck said:
If your liver is anything like a deer's liver, you're going to DIE. Of course this is based on observations of hits by a rifle round. Most of the deer hit with .25+cal bullets died within a few seconds-most on the spot.
"Kicked in the liver"??? Maybe kicked in the lower back near the liver. Pretty sure a kick hard enough to affect your liver will also have an effect on the spine causing some loss of function of the lower limbs.
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Not to get too off course, but there are self defense disciplines that use your opponent's liver and kidneys to great advantage. A punch to the liver can be quite painful. Believe me.

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I'm sure that a blow to the lower abdomen that involves the liver would be stunning merely because of the location and organs involved. The body's reaction when it has a bullet wound in it is different. A surprising number of people with potentially deadly wounds never feel them.
Livers have a lot of blood flow through them and as such are a dangerous place to be hit with a bullet. Hearts and lungs are better though, because you either catastrophically lower the blood pressure(heart) or affect their ability to breathe(lungs). A lung hit normally collapses a lung fairly quickly.
I've seen a lot of lacerated livers that people lived through even though the blood loss was significant. Bottom line I've seen patients come in awake and functioning with the equivalent of a GSW to the liver. Put as many holes in the chest/abdomen area as possible and hope for the best, human bodies are made to keep funtioning with much more damage than you think. Take my opinion for what its worth, 20 years of trauma nursing behind it.
 
scrubcedar said:
I'm sure that a blow to the lower abdomen that involves the liver would be stunning merely because of the location and organs involved. The body's reaction when it has a bullet wound in it is different. A surprising number of people with potentially deadly wounds never feel them.
Livers have a lot of blood flow through them and as such are a dangerous place to be hit with a bullet. Hearts and lungs are better though, because you either catastrophically lower the blood pressure(heart) or affect their ability to breathe(lungs). A lung hit normally collapses a lung fairly quickly.
I've seen a lot of lacerated livers that people lived through even though the blood loss was significant. Bottom line I've seen patients come in awake and functioning with the equivalent of a GSW to the liver. Put as many holes in the chest/abdomen area as possible and hope for the best, human bodies are made to keep funtioning with much more damage than you think. Take my opinion for what its worth, 20 years of trauma nursing behind it.
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I was in no way comparing a blow to the liver to a bullet to the liver. I was just saying that a blow to the liver or kidney can leave an adversary incapacitated or at the very least stunned enough to gain a combat or tactical advantage.

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Perhaps I am wrong, but I think the information quoted by Friar Whently is old and based on low velocity handgun bullets, either solid lead or full metal jacket. It does not seem to take into account modern high velocity bullets or calibers like the .357 Magnum or .44 Magnum, let alone 5.7, .454 Casull, and the like.
Click to expand...

Sorta'. The book was published in 1999, so it's not THAT old. However, you are correct that non-FMJ ammo will create a temporary cavity at lower velocities than FMJ, except there still seems to be a velocity threshold that needs to be reached for it to occur with much severity. Another passage from the same book I quoted in my previous post:

"It is the author’s belief that rather than there being a critical velocity
above which the severity of wounds increases dramatically, there is instead a critical level (amount) of kinetic energy loss above which tissue destruction becomes radically more severe. This level is different for each organ or tissue. When a bullet or missile exceeds this kinetic energy threshold, it produces a temporary cavity that the organ or tissue can no longer contain, i.e., one that exceeds the elastic limit of the organ. When the elastic limit is exceeded, the organ “bursts.” For full metal-jacketed rifle bullets and steel balls to reach this critical level of kinetic energy loss, these missiles must be traveling at very high velocities (greater than 800 to 900 m/sec; 2625 to 2950 ft/s). For soft-point and hollow-point rifle bullets, however, the same loss of kinetic energy will occur at lower velocities as a result of the deformation and breakup of the bullets. Thus, in the author’s experience, for hunting bullets the critical velocity, appears to be between 1500 and 2000 ft/sec (457 to 610 m/sec)."

There isn't too much handgun ammo out there pushing bullets >1,500 fps, though it certainly does exist with the larger calibers (.454 Casull, etc.).
 
It occurs to me that blunt force trauma, like a kick or punch, would not really be comparable to penetrating trauma, like a bullet wound.

Perhaps those in this thread with real medical training might be good enough to comment on the differences, if any.
 
I am an internist and not a trauma surgeon, but blunt trauma can do major damage as the man in Texas who killed the man molesting his daughter found out. Nothing to sneeze at at all, but not in the same category as gunshots, especially when looking at high velocity gun shot wounds with hydrostatic shock causing a wide area of devitalized tissues which are obviously much more deadly.

Kicking someone in the right upper abdomen/costal rib area can lead to numerous types of injuries especially if a rib is broken and punctures the liver. Liver tissue bleeds profusely and is one organ that is treated with great care during surgery. Injuries to the liver are not easy to repair as well.

The bottom line, you don't want blunt force trauma or gunshot to your liver, both could leave you lifeless very easily.
 
I don't know about you, but all this talk about getting kicked and stabbed in the liver and kidneys is really making me rethink that plate carrier...;)
 
Most of the liver lacerations I saw came out of auto accidents, thinking back I can only remember clearly one that was a penetration injury, a fall onto rebar. My experience only extends to what the outside looked like, what we did to solve the problem, and who made it or didn't.
I think Alaska444 is probably right about repairing that sort of damage in surgery. I was mainly commenting on the effectiveness of a hole in the liver to stop the fight quickly.
When arteries were hit they quite often didn't make it to us. Hearts, even more so. Lungs, they made it if they got professional care at the scene but were in no shape to fight. Liver lacerations made it to us quite often awake even after having to be extracted at the scene. Blunt force different than penetration?, no question, pretty different. I have to agree with Alaska444 on that the person to ask is a trauma surgeon we certainly weren't cutting them open to see what the wound channel looked like or where exactly the bullet went and what it did on the way.
 
Temporary cavity can certainly do deadly damage, but it's often labelled as "unreliable" because how much real damage it does is dependent on what type of tissue it involves and much of the body tissues are too elastic to be signficantly damaged by temporary cavity.

It may sound silly, but I think that one of the biggest benefits of temporary cavity is that it dramatically increases the chances that your opponent will instantly realize he's been shot. When you're armed with a handgun, your most potent weapon is your opponent's fear of serious injury or death.
 
Today, 04:38 PM #18
scrubcedar
Member

Join Date: May 3, 2012
Location: Northern UT
Posts: 66
Most of the liver lacerations I saw came out of auto accidents, thinking back I can only remember clearly one that was a penetration injury, a fall onto rebar. My experience only extends to what the outside looked like, what we did to solve the problem, and who made it or didn't.
I think Alaska444 is probably right about repairing that sort of damage in surgery. I was mainly commenting on the effectiveness of a hole in the liver to stop the fight quickly.
When arteries were hit they quite often didn't make it to us. Hearts, even more so. Lungs, they made it if they got professional care at the scene but were in no shape to fight. Liver lacerations made it to us quite often awake even after having to be extracted at the scene. Blunt force different than penetration?, no question, pretty different. I have to agree with Alaska444 on that the person to ask is a trauma surgeon we certainly weren't cutting them open to see what the wound channel looked like or where exactly the bullet went and what it did on the way.
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Gaily bedight, A gallant knight In sunshine and in shadow, Had journeyed long, Singing a song, In search of El Dorado
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+1 scrubcedar, I have the greatest respect for trauma surgeons. I saw enough auto accidents as a medical student to know how small a space they work and how much can go wrong and/or be missed. Just saw a murder report where the surgeons failed to find a nick in the subclavian artery after a stabbing. By the time they found it, he was in shock and did not recover.

I remember one trauma where the diaphragm was ruptured. The resident doing the surgery accidentally cut the liver when he was removing scar tissue and getting an angle to sow up the diaphragm. Made things very interesting. Once again, you have to have a certain fortitude to excel in that arena.
 
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