title: Non-operative management of hepatic trauma and the interventional radiology: an update review.
abstract: The growing trend to manage hepatic injuries nonoperatively has been increasing demand for advanced endovascular interventions. This brings up the necessity for general and trauma surgeons to update their knowledge in such matter. Effective treatment mandates a multispecialty team effort that is usually led by the trauma surgeon and includes vascular surgery, orthopedics, and, increasingly, interventional radiology. The focus on hemorrhage control and the angiographer's unique access to vascular structures gives interventional radiology (IR) an important and increasingly recognized role in the treatment of patients with hemodynamic instability. Our aim is to review the basic concepts of IR primarily in hepatic trauma and secondarily in some other special situations. A liver vascular anatomy review is also needed for better understanding the roles of IR. As a final point we propose a guideline for the operative/nonoperative management of traumatic hepatic injuries. The benefit of multidisciplinary approach (TAE) appears to be a powerful weapon in the medical arsenal against the high mortality of injured trauma liver patients.
authors.affiliation: Division of Trauma Surgery, Department of Surgery, School of Medical Sciences (FCM), University of Campinas (UNICAMP), Campinas, SP Brazil ; Faculty of the Division of Trauma Surgery, School of Medicine-University of Campinas-UNICAMP, Campinas, Brazil ; UNICAMP, 181 Rua Alexander Fleming, 13.083-970 Campinas, SP Brazil.
authors.forename: Bruno Monteiro Tavares
authors.initials: BM
authors.lastname: Pereira
keywords: Angioembolization; Hepatic trauma; Interventional radiology; Non-operative management of hepatic trauma