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If the patient fails to respond to blood transfusion then ongoing haemorrhage is to be suspected and an urgent laparotomy is required.

The first goal is control of haemorrhage:

  • sutures or packing may suffice
  • radical manoeuvres require temporary occlusion of:
    • the inferior vena cava above and below the liver
    • the portal vein
    • the hepatic artery

The second goal is removal of devitalized liver fragments:

  • may require complete liver lobectomy

Haemobilia is a complication of liver trauma.

Last reviewed 01/2018