Non-Operative Management of Adult Blunt
Hepatic Trauma Algorithm


This is a recommended algorithm of the Western Trauma Association (WTA) for the management of blunt hepatic injuries. Because there are no published prospective randomized trials, the recommendations are based on available published prospective, observational, and retrospective data and expert opinion of WTA members. The algorithm (Figure 1) and accompanying text represent safe and reasonable treatment strategies that could be followed at most trauma centers. We recognize that there will be variability in decision making and institutional and patient specific factors that may warrant deviation from the recommended algorithm. We encourage institutions to use this algorithm as a basis to develop institution-specific protocols. The algorithm contains letters which correspond to the text. Their purpose is to explain the critical factors affecting decisions and to guide the reader through the algorithm.1,2 References to support each step are inserted as appropriate. Specific areas where published data are lacking are mentioned as potential topics for future studies.