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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