**1. Introduction**

Despite its well-protected position, the liver is the most frequently affected abdominal organ by blunt or penetrating trauma [1, 2]. Over the past decades, the improvements in the assessment and management of hepatic injury have evolved significantly, thus resulting in better outcomes for affected patients [3]. The majority of such injuries develop following high-energy traffic accidents or violent behaviors [4]. Industrial and farming accidents also consist of a significant percentage of liver trauma. Blunt injuries are the majority of cases in Europe, Australia, and Asia, whereas penetrating injuries (stab and gunshot wounds) are most frequently encountered in North America and South Africa [5, 6].

Blunt trauma, as a result of traffic accident or fall from a height, may lead to deceleration injury due to the inertia of the liver [4]. The affected sites usually involve the attachments to the diaphragm and abdominal wall. These types of injury typically involve the right lobe, especially the posterior segments, and the caudate lobe, while a vascular injury may also be present with the respective hepatic arteries, portal and hepatic veins being affected [4, 7, 8]. The site of connection between inferior vena cava and hepatic veins is vulnerable to blunt traumas and may lead to serious venous injuries and a significant blood loss. Penetrating injuries are more frequently associated with significant vascular injuries at the liver site inflicted [4].

In this chapter, we aimed to describe the classification and appropriate investigations of liver injuries and elaborate on the use of damage control surgery (DCS) in this setting.
