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Objective To investigate the etiology and pathogenesis of hepatic stress injury after trauma.Methods 4677 patients with severe trauma in 153th Hospital of PLA from Jan.2004 to Jul.2005 were enrolled in this study to investigate the incidence of hepatic stress injury,and furthermore,in combination with medical information,the possible pathogenesis was analyzed.Results The main manifestation of hepatic stress injury was the elevated ALT or AST levels (387 cases,8.3％ ).The incidence of hepatic stress injury after hand injury,burn injury,head injury,bone injury,abdominal injury,and thoracic injury were 16.6％,6.9％,5.6％,5.0％,3.8％ and 2.0％,respectively,and among which,the incidence of hepatic stress injury after hand injury was statistically highest (P ＜0.01 ).Conclusion The total incidence of hepatic stress injury after trauma was 8.3％.Intestinal endotoxemia might be one of the beginning components of hepatic stress injury after trauma.