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Reimaging High-Grade Blunt Hepatic Injuries: Revisiting the Role of Routine Surveillance in Modern Nonoperative
Caitlyn Braschi1, Paul Brosnihan2, Lara Senekjian3
1Department of Surgery, University of Southern California, Los Angeles, California.
The Journal of Surgical Research
|January 23, 2026
Summary
Routine imaging surveillance for traumatic liver injuries is crucial, especially for higher-grade injuries. Repeat imaging in the initial days post-trauma identifies patients needing reintervention, improving outcomes.
Area of Science:
- Trauma Surgery
- Abdominal Imaging
- Surgical Outcomes
Background:
- Traumatic liver injuries present significant morbidity and mortality risks.
- The utility of routine post-injury imaging surveillance remains unclear, particularly for severe injuries.
Purpose of the Study:
- To evaluate the role of repeat imaging in managing blunt traumatic liver injuries.
- To compare outcomes between lower-grade liver injuries (LGLI) and higher-grade liver injuries (HGLI).
Main Methods:
- Multicenter retrospective review of adults with American Association for the Surgery of Trauma grades II-V liver lacerations.
- Comparison of reimaging patterns, reintervention rates, and 30-day outcomes between LGLI (grades II-III) and HGLI (grades IV-V).
Main Results:
- Higher-grade liver injuries (HGLI) were more frequently reimaged (69.2% vs. 32.7%).
- HGLI patients experienced higher rates of liver-specific complications (23.1% vs. 2.0%) and required more reinterventions (19.2% vs. 2.6%).
- HGLI was independently associated with reimaging (OR 3.10) and higher 30-day mortality (27.5% vs. 10.0%).
Conclusions:
- A significant proportion of HGLI patients require reintervention, underscoring the need for careful monitoring.
- Routine imaging surveillance should be considered for patients with traumatic liver injuries due to the high rate of reintervention.
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