Table 1: Classification of liver injury (adapted from the American Association for the Surgery of Trauma (AAST) guidelines [22].

Grade

Laceration

Haematoma

Vascular Injury

I

Capsular tear

·        < 1 cm depth

Sub-capsular

·        < 10% surface area

 

II

Intra-parenchymal

·        < 10 cm diameter

·        1-3 cm depth

·        < 10 cm length

Sub-capsular

·        10-50% of surface area

 

III

Intra-parenchymal

·        > 3 cm depth

Sub-capsular

·        50% surface area/expanding

·        ruptured

Intra-parenchymal

·        10 cm/expanding

·        ruptured

 

IV

Parenchymal disruption

·        25-75% of hepatic lobe

·        1-3 Couinaud segments within a single lobe

 

 

V

Parenchymal disruption

·        75% of hepatic lobe

·        > 3 Couinaud segments within a single lobe

 

Juxta-hepatic venous injuries

·        retro-hepatic cava

·        major hepatic veins

VI

 

 

Hepatic avulsion