Hepatic and splenic trauma

The spleen and liver are two organs commonly injured in various forms of abdominal trauma. Their relative size, relatively fixed positions, and abundant vascular supply make them prone both to injury and potential sources of catastrophic haemorrhage. With the evolution of computed tomography (CT), there has been a paradigm shift in the management of such injuries from operative to non-operative means. Advances in imaging techniques have also enabled clinicians to observe such patients for development of complications, and when appropriate, utilise the repertoire of interventional radiology techniques available. This review aims to summarise the epidemiology of splenic and hepatic trauma, the mechanisms of trauma and the classifications used in describing these injuries. The role of commonly used imaging modalities, namely ultrasound and CT, both in the acute setting and in observation of these patients for delayed complications is described, and finally a brief description of the current management strategies of such injuries is given.