Most preventable deaths from trauma are caused by unrecognised and therefore untreated haemorrhage, particularly in the abdomen. Haemorrhage causes early deaths, and the associated hypovolaemic shock leads to secondary brain injury and contributes to late death from multiorgan failure.1 Early management is focused on resuscitation and the diagnosis and treatment of life threatening bleeding to prevent the lethal metabolic disturbance triad of acidosis, hypothermia, and coagulopathy.2

Many aspects of immediate trauma care suffer from a lack of high quality prospective research. This review is based predominantly on evidence from retrospective cohort series and is subject to the limitations inherent in this type of level 2 research.3 There are no prospective randomised controlled trials of interventional radiology in major trauma. Although the volume of level 2 evidence is substantial and contains few contradictory findings, no robust level 1 evidence yet exists. This review aims to summarise the evidence supporting the use of interventional radiological techniques in the management of haemorrhage caused by blunt abdominal trauma.