The blunt liver trauma: Review of current diagnostic and management strategies

Abstract

The liver is one of the most commonly injured organs in blunt abdominal trauma. Major liver trauma in polytraumatic patients accounts for significant morbidity and mortality. Therapeutic options for blunt hepatic trauma include both non-operative and operative management. Hemodynamic status, not the grade of the injury, should dictate the management. CT scan of the abdomen and pelvis is a standard diagnostic modality in hemodynamically stable trauma patients. Recent advancements in imaging studies and enhanced critical care strategies have shifted the paradigm for the management of liver injuries. Nonoperative management of both low- and high-grade injuries can be successful in hemodynamically stable patients. Direct suture of bleeding vessels, vascular isolation of the liver, and damage control surgery have improved outcomes in the hemodynamically unstable patients. We have reviewed current position in the treatment of blunt hepatic trau

Keywords

• Liver injury
• perihepatic packing; damage control surgery (DCS)
• angioembolization
• haemodynamic instability
• focused assessment by ultrasound for trauma (FAST)
• computed tomography (CT)
• intensive care unit (ICU)