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Liver trauma injury grading

Dr Alexandra Stanislavsky and Dr Frank Gaillard et al.

The AAST Liver injury grading system is as follows

grade I :
- haematoma: sub capsular, < 10% surface area
- laceration: capsular tear, < 1cm depth
grade II :
- haematoma: sub capsular, 10 - 50% surface area
- haematoma: intraparenchymal < 10cm diameter
- laceration: capsular tear, 1 - 3cm depth, < 10cm length
grade III :
- haematoma: sub capsular, > 50% surface area, or ruptured with active bleeding
- haematoma: intraparenchymal > 10 cm diameter
- laceration: capsular tear, > 3 cm depth
grade IV :
- haematoma: ruptured intraparenchymal with active bleeding
- laceration: parenchymal distruption involving 25 - 75% hepatic lobes or
- 1 - 3 Couinaud segments (within one lobe)
grade V :
- laceration: parenchymal distruption involving >75% helpatic lobe or
- > 3 Couinaud segments (within one lobe)
- vascular: juxtahepatic venous injuries (IVC, major hepatic vein)
grade VI : vascular: hepatic avulsion

References

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1. Yoon W, Jeong YY, Kim JK et-al. CT in blunt liver trauma. Radiographics. 25 (1): 87-104. doi:10.1148/rg.251045079 - Pubmed citation