Liver injury-trauma grading
Liver injuries are graded I-VI with increasing severity having higher grading (e.g. grade VI injuries are not salvageable).
- Hepatic subcapsular hematoma of <10% surface area
- Hepatic capsular tear/laceration <1 cm in parenchymal depth
- Hepatic subcapsular hematoma of 10-50% surface area
- Intraparenchymal hematoma <10 cm diameter
- Hepatic laceration 1-3 cm parenchymal depth, <10 cm length
- Hepatic subcapsular hematoma of >50% surface area or expanding
- Ruptured hepatic subcapsular or parenchymal hematoma
- Intraparenchymal hematoma >10 cm diameter or expanding
- Hepatic laceration of >3 cm parenchymal depth
- Hepatic laceration with parenchymal disruption of >25-75% of hepatic lobe or 1-3 Coinaud's segments in a single lobe
- Hepatic laceration with parenchymal disruption of >75% of hepatic lobe or >3 Coinaud's segments within a single lobe
- Juxtahepatic venous injury (retrohepatic vena cava or central major hepatic veins)
- Hepatic avulsion
Note that one grade increase is indicated for multiple injuries to the liver up to a grade of III.
Moore EE, et al. Organ injury scaling: spleen and liver (1994 revision). J Trauma. 1995;38:323-4.
Trauma scoring. Trauma.org. Available at http://www.trauma.org/archive/scores/ois-liver.html (Accessed 23 April 2008)