Treatment of Major Hepatic Hemorrhage in Complex Hepatic Injury

Major hepatic hemorrhage arising from complex hepatic injury is one of the most immediately life-threatening presentations of blunt abdominal trauma. Rapid, structured intervention is essential — the central priority is achieving hemorrhage control before irreversible physiological deterioration occurs.

This protocol is directed at patients presenting with major hepatic hemorrhage as a consequence of complex hepatic injury — a scenario in which surgical hemorrhage control and aggressive resuscitation must proceed in parallel.

The initial step is manual compression of the injured hepatic parenchyma. From there, the protocol follows a damage control framework — combining surgical packing, systemic resuscitation measures, and physiological correction. The complete stepwise algorithm, including subsequent surgical and interventional considerations, is available in the full protocol.