What AAST grade is this liver injury?
Grade V liver lacerations with signs of active extravasation.
Should this patient proceed to theatre or angiography?
This depends on availability of angiography and the patient's haemodynamic status. If the patient is haemodynamically unstable, this is typically an indication for trauma laparotomy.
No aortic injury No pneumothorax or haemothorax. The central airways are patent.
Multiple liver lacerations are detected affecting most of the right liver. The lacerations extend to the hilum. There is active extravasation of contrast within segment five of the liver, related to the right anterior branch of the hepatic artery (or portal vein).
The liver lacerations are associated with a moderate amount of haemoperitoneum. Haemorrhage is seen around the right adrenal gland. The left adrenal gland is normal.
The right sixth, seventh, eighth, ninth rib fractured laterally.