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Liver trauma injury grading

The AAST liver injury grading system for liver trauma 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 involves 1-3 Couinaud segments (within one lobe)
  • grade V 
    • laceration: parenchymal distruption involving >75% helpatic lobe or involves > 3 Couinaud segments (within one lobe)
    • vascular: juxtahepatic venous injuries (IVC, major hepatic vein)
  • grade VI 
    • vascular: hepatic avulsion 

See also

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