Fig. 1

Liver Trauma Management Algorithm. (SW Stab Wound, GSW Gun Shot Wound; *NOM should only be attempted in centers capable of a precise diagnosis of the severity of liver injuries and capable of intensive management (close clinical observation and haemodynamic monitoring in a high dependency/intensive care environment, including serial clinical examination and laboratory assay, with immediate access to diagnostics, interventional radiology and surgery and immediately available access to blood and blood products; # wound exploration near the inferior costal margin should be avoided if not strictly necessary because of the high risk to damage the intercostal vessels; @ extremely selected patients hemodynamically stable with evisceration and/or impalement and/or diffuse peritonitis with the certainty of an exclusive and isolated abdominal lesion could be considered as candidate to be directly taken to the operating room without contrast enanched CT-scan)