Jun 21, 2012

Liver injury grading system

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 segments (within one lobe)
  • grade V
    • laceration : parenchymal distruption involving >75% helpatic lobe or
    • > 3 segments (within one lobe)
    • vascular : juxtahepatic venous injuries (IVC, major hepatic vein)
  • grade VI : vascular : hepatic avulsion