Liver Injury Grading System
Grade I-
Hematoma- Subcapsular < 10% of surface area.
Laceration- Capsular tear < 1 cm in depth.
Grade II-
Hematoma-
Subcapsular 10- 50% surface area
Intraparenchymal < 10 cm in diameter.
Laceration- 1-3 cm in depth or <10 cm in length.
Grade III-
Hematoma-
Subcapsular < 50% surface area or expanding or ruptured subcapsular hematoma with active bleeding.
Intraparenchymal > 10 cm or expanding or ruptured.
Laceration > 3 cm in depth.
Grade IV-
Hematoma- Ruptured intraparenchymal hematoma with active bleeding.
Laceration- Parenchymal disruption involving 25- 75% of a hepatic lobe.
Grade V-
Laceration. Parenchymal disruption involving > 75% of a hepatic lobe.
Vascular- Juxtahepatic venous injuries (IVC or central hepatic veins).
Grade VI-
Hepatic avulsion.
Hematoma- Subcapsular < 10% of surface area.
Laceration- Capsular tear < 1 cm in depth.
Grade II-
Hematoma-
Subcapsular 10- 50% surface area
Intraparenchymal < 10 cm in diameter.
Laceration- 1-3 cm in depth or <10 cm in length.
Grade III-
Hematoma-
Subcapsular < 50% surface area or expanding or ruptured subcapsular hematoma with active bleeding.
Intraparenchymal > 10 cm or expanding or ruptured.
Laceration > 3 cm in depth.
Grade IV-
Hematoma- Ruptured intraparenchymal hematoma with active bleeding.
Laceration- Parenchymal disruption involving 25- 75% of a hepatic lobe.
Grade V-
Laceration. Parenchymal disruption involving > 75% of a hepatic lobe.
Vascular- Juxtahepatic venous injuries (IVC or central hepatic veins).
Grade VI-
Hepatic avulsion.