Abstract
Non-operative management of blunt hepatic injury has become a mainstream therapy since the broadening of selection criteria after the addition of TAE to conservative management strategies in the mid-1970s. TAE has begun to be employed for the management of type III blunt hepatic injury because of its advantages over operative management, including a reduced need for blood transfusion and a shorter period of hospitalization. Since reports of patient deaths caused by the misapplication of TAE have been made, however, the selection criteria for this procedure need to be firmly established. The management of type III blunt hepatic injury cannot be solely determined by the classification of hepatic injury according to computed tomography (CT) results; the hemodynamics and severity of injuries from complications involving other organs should also be taken into consideration. We established criteria for TAE, conservative management, and operative management based on blood pressure, reaction to transfusion, and CT classification, and obtained favorable results in their application to type III blunt hepatic injuries. Here, we discuss the selection criteria for TAE in type III blunt hepatic injury, including our experiences.
