Vascular emergencies in liver trauma

Area of Science:

• Radiology
• Trauma Surgery
• Emergency Medicine

Background:

• Computed tomography (CT) has transformed the management of traumatic liver injuries, influencing surgical versus non-surgical treatment choices.
• Vascular injury is the primary cause of complications and mortality in liver trauma.
• Effective CT interpretation is vital for accurate diagnosis and patient outcomes.

Purpose of the Study:

• To review CT findings in liver trauma, focusing on vascular complications.
• To describe elementary CT lesions, potential diagnostic pitfalls, and essential reporting elements.
• To discuss CT-based grading systems, early and delayed diagnostic strategies, and interventional radiology.

Main Methods:

• Review of current literature on CT imaging in liver trauma.
• Analysis of CT features indicative of vascular injury and other complications.
• Discussion of diagnostic algorithms and interventional treatment considerations.

Main Results:

• CT can identify various liver trauma lesions including lacerations, hematomas, devascularization, active bleeding, pseudoaneurysms, and bile leaks.
• Understanding CT findings aids in differentiating surgical from non-surgical management, even in high-grade injuries.
• CT grading systems provide a framework for assessing injury severity and guiding treatment.

Conclusions:

• CT is indispensable for the comprehensive evaluation of liver trauma, particularly for vascular complications.
• Accurate CT interpretation and reporting are critical for optimal patient management and outcomes.
• Diagnostic strategies should integrate CT findings with clinical status for timely interventions like arterial embolization.