Management of Blunt Hepatic Trauma

Management of Blunt Hepatic Trauma

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Western Trauma Association Critical Decisions in Trauma: Nonoperative Management of Adult Blunt Hepatic Trauma J. Trauma. Volume 67(6), December 2009, pp 1144-1149

American Association for the Surgery of Trauma Liver Injury Scale

Grade	Injury Description
I. Hematoma Laceration	Subcapsular, nonexpanding, <10% surface area Capsular tear, nonbleeding, <1 cm parenchymal depth
II. Hematoma Laceration	Subcapsular, nonexpanding, 10–50% surface area; intraparenchymal, nonexpanding, <10 cm in diameter Capsular tear, active bleeding; 1–3 cm parenchymal depth, <10 cm in length
III. Hematoma Laceration	Subcapsular, >50% surface area or expanding; ruptured subcapsular hematoma with active bleeding; intraparenchymal hematoma, >10 cm or expanding >3 cm parenchymal depth
IV. Hematoma Laceration	Ruptured intraparenchymal hematoma with active bleeding Parenchymal disruption involving 25–75% of hepatic lobe or 1–3 Couinaud's segments within a single lobe
V. Hematoma Vascular	Parenchymal disruption involving >75% of hepatic lobe or >3 Couinaud's segments within a single lobe Juxtahepatic venous injuries, i.e., retrohepatic vena cava/central major hepatic veins
VI. Vascular	Hepatic avulsion