• Nicholas Fischer and Adam Bartlett.
• New Zealand Liver Transplant Unit, Auckland, New Zealand; Trauma Services, Auckland City Hospital, New Zealand. Electronic address: NFischer@adhb.govt.nz.
• Injury. 2022 Jan 1; 53 (1): 86-91.

BackgroundSurveillance imaging following liver trauma (LT) in asymptomatic patients is performed in many centers. Recent guidelines recommend follow-up imaging if there is a clinical indication.AimTo compare liver complications detected through surveillance versus selective imaging in patients following known LT.MethodsA retrospective review of a prospective trauma registry was undertaken including all patients that presented with LT at a single center. All radiology images and reports of patients with LT were reviewed. The indication for follow-up imaging was ascertained by reviewing the radiology request and the patients' clinical record.ResultsDuring the 14-year study, 450 patients were admitted with LT. Liver complications occurred in 50 patients (11%). Follow-up imaging was performed in 169 patients (38%). Of the patients having follow-up imaging, 92 patients had this for clinical deterioration, 55 had surveillance imaging and 22 had follow-up imaging for a non-liver indication. The majority of patients undergoing surveillance imaging had an AAST grade III-V injury (68%). None of the 55 patients having surveillance imaging had a liver complication. In contrast, 36 out of 92 patients having follow-up imaging for clinical deterioration had a complication within their liver (39%). There was a significantly higher incidence of complication detection for clinical deterioration versus surveillance imaging (p = < 0.0001).ConclusionsAlthough complications following high-grade LT are common, they invariably cause clinical deterioration. There is no evidence for surveillance imaging following LT. Follow-up imaging should be guided by the patient's clinical condition.Copyright © 2021 Elsevier Ltd. All rights reserved.

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