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Complications Associated with Non-Operative Management of Blunt Hepatic Injury: a Review

Non-operative management (NOM) is considered the gold standard treatment for blunt liver trauma in hemodynamically stable patients since it is both feasible and safe. The reported rate of NOM ranged from 82 to 100% according to different series. The feasibility of NOM is lower in patients with severe liver injury. Since NOM has reduced mortality rates, the focus now has shifted to lowering hepatic morbidity, which is reported to be significant, from 10 to 25%. There are four types of complications after NOM: abdominal compartment syndrome, bleeding, Infectious complications and biliary complications. When present, complications of complex blunt hepatic injuries are difficult to treat, the hospital stay is longer and the ICU mortality is higher. 85% of these complications can be safely managed non-operatively. A strict clinical follow-up and keeping in mind every possible complication let clinicians diagnose and treat quickly.