Splenic, pancreatic, and hepatic injuries.

The preoperative resuscitation and operative management of hepatic trauma has vastly improved over the past 50 years. The majority of patients can be handled with simple techniques, with close attention to local hemostasis and adequate drainage. When major liver trauma does occur, exsanguination remains the leading cause of death. An integrated effort of physicians, nurses, and ancillary hospital support staff is needed to care for these severely injured patients.