Liver Trauma Management: Three-Year Experience in a Tertiary Trauma Center.

Introduction: Liver injury is a frequent and frequently fatal consequence of both blunt and penetrating abdominal trauma. Due to its extensive vascularization and central position, hepatic trauma necessitates early and multidisciplinary treatment. Improvements in imaging, critical care, and interventional radiology over the past decade have made nonoperative management feasible for select individuals. Objective: To review the management plan, outcomes, and complications of liver trauma cases in a tertiary trauma center for three years. Materials and Methods: A retrospective analysis was performed on patients admitted with liver trauma between January 2022 and December 2024. Information on demographics, mechanism of injury, severity of injury (based on the AAST liver injury scale), imaging findings, type of treatment, and outcome was gathered. Results: 65% of the 186 patients presented with blunt trauma and 35% with penetrating trauma. Nonoperative management was applied in 144 (77.4%) of the cases with a success rate of 94.4%. Surgery was required in 42 (22.6%) cases, often due to hemodynamic instability or high-grade injury. Overall mortality was 9.1%, which was mainly due to severe trauma and concomitant injuries, interventional radiology, i.e., hepatic artery embolization, and enhanced nonoperative management success. Operative patients had higher incidences of complications such as bile leakage and intra-abdominal sepsis. Conclusion: Nonoperative therapy is effective and safe for most liver injury situations, provided that patient selection is correct. Surgery remains essential for unstable patients. A multidisciplinary, individualized strategy, aided by modern imaging and interventional tools, optimizes outcomes and minimizes morbidity.