Table 2: Key points.
· 80% of liver trauma is minor and can be managed conservatively |
· Independent risk factors for failure of non-operative management include; · Patient age · Need for blood products · Active haemorrhage on CT |
· Trauma patients who develop hypothermia require more blood products and have a higher mortality rate. |
· Angioembolisation is effective in up to 90% of cases. |
· TEG and ROTEM can provide quick identification of bleeding due to trauma-induced coagulopathy (TIC) or hyperfibrinolysis (excessive clot lysis). |
· Operative management is usually indicated in patients where initial resuscitation attempts have been futile and interventional radiological management is not available or appropriate. |