Liver trauma management: a review of long-term outcome, advanced imaging, and comorbidities
DOI:
https://doi.org/10.58342/MJ.V.3.I.1.15Keywords:
Liver trauma; Long-term outcomes, Advanced imaging techniques, Non-operative managementAbstract
Background and Objective: Management of trauma-related liver injury has undergone significant changes over the past four decades. In hemodynamically stable patients, the standard of care in most level-one trauma centers has shifted toward nonoperative management with high success rates, particularly in low-grade liver injuries such as grade I and II. Advances in critical care medicine, cross-sectional imaging, and transarterial embolization techniques have contributed to improved patient outcomes and reduced mortality in patients with arterial injuries. These developments have allowed clinicians to manage many cases of liver trauma without the need for open surgery.
Method: A selective literature search was conducted in PubMed and Google Scholar for studies published between 2020 and 2025 focusing on nonoperative management of liver trauma and the role of hepatic angiography and transarterial embolization.
Findings/Results: Current literature indicates that nonoperative management of liver injuries in hemodynamically stable patients, particularly with the use of hepatic angiography and transarterial embolization (TAE), is an effective and relatively low-complication approach. However, no consensus guidelines regarding appropriate patient selection criteria have yet been published by the Society of Interventional Radiology (SIR) or the American Association for the Surgery of Trauma (AAST). Evidence suggests that TAE improves the success rate of nonoperative management and is generally well tolerated by most patients. Hepatic necrosis remains the most commonly reported complication but can be minimized through selective embolization techniques and appropriate choice of embolic agents.
Conclusion: Nonoperative management combined with hepatic angiography and transarterial embolization should be considered an important treatment option for hemodynamically stable patients with suspected arterial injury. Further prospective multicenter studies with larger sample sizes are needed to better evaluate the efficacy and safety of TAE in trauma-related liver injury.
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