Abstract
The severity of liver injuries has been universally classified according to the American Association for the Surgery of Trauma (AAST) grading scale. In determining the optimal treatment strategy, however, the haemodynamic status and associated injuries should be considered. Thus the management of liver trauma is ultimately based on the anatomy of the injury and the physiology of the patient. This paper presents the World Society of Emergency Surgery (WSES) classification of liver trauma and the management Guidelines.
Highlights
The severity of liver injuries is universally classified according to the American Association for the Surgery of Trauma (AAST) grading scale (Table 1) [1]
The majority of patients admitted for liver injuries have grade I, II or III and are successfully treated with nonoperative management (NOM)
In many cases there is no correlation between AAST grade and patient physiologic status
Summary
The severity of liver injuries is universally classified according to the American Association for the Surgery of Trauma (AAST) grading scale (Table 1) [1]. The majority of patients admitted for liver injuries have grade I, II or III and are successfully treated with nonoperative management (NOM). Almost two-thirds of grade IV or V injuries require laparotomy (operative management, OM) [2]. In many cases there is no correlation between AAST grade and patient physiologic status. In determining the optimal treatment strategy, the AAST classification should be supplemented by hemodynamic status and associated injuries. In clinical practice the decision whether patients need to be managed operatively or undergo NOM is based mainly on the clinical conditions and the
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