Table of contents
Liver trauma
What's new
Added 2020 WSES guidelines for the evaluation and management of liver trauma.
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of liver trauma are prepared by our editorial team based on guidelines from the European Federation of Societies for Ultrasound (EFSU 2020), the Society of Interventional Radiology (SIR 2020), the World Society of Emergency Surgery (WSES 2020), the World Society of Emergency Surgery (WSES/AAST 2019), and the Eastern Association for the...
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Diagnostic investigations
Ultrasound: as per WSES 2020 guidelines, Obtain eFAST for rapid detection of intra-abdominal free fluid.
A
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CT
MRCP
Hepatobiliary scintigraphy
Diagnostic procedures
Medical management
Setting of care: as per WSES 2020 guidelines, Consider admitting patients with isolated liver injury with moderate (WSES II/AAST III) or severe (WSES III/AAST IV-V) lesions to an ICU.
C
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Nonoperative management
Thromboprophylaxis
Nonpharmacologic interventions
Enteral feeding: as per WSES 2020 guidelines, Initiate enteral feeding as soon as possible in the absence of contraindications in patients with liver injury.
B
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Early mobilization
Therapeutic procedures
Angiography with embolization: as per SIR 2020 guidelines, Consider performing embolization in patients with blunt hepatic injury with ongoing bleeding, identification of an arterial source of bleeding on imaging, or suspicion of a persistent source of arterial bleeding despite operative intervention.
C
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REBOA
Other interventions for complications