A patient with traumatic liver injury may be managed without surgical exploration if certain criteria are identified.
A patient with traumatic liver injury and all of the following findings is a candidate for non-operative management:
(1) hemodynamically stable after initial resuscitation
(2) abdominal pain and/or tenderness are neither persistent nor increasing
(3) no other peritoneal injuries that would justify laparotomy
(4) blood transfusion requirements < 4 units packed RBCs
(5) hemoperitoneum < 500 mL on abdominal CT
(6) abdominal CT shows a simple hepatic parenchymal laceration or intrahepatic hematoma
A patient who fails to meet one or more of the criteria should be evaluated for surgery.
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Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general, Gastroenterology
ICD-10: ,
