The American Association for the Surgery of Trauma (AAST) grades solid organ injuries. A Grade IV liver laceration is defined as:

• A Subcapsular haematoma <10% surface area; capsular laceration <1 cm deep
• B Parenchymal laceration 3-10 cm depth involving no hepatic veins
• C Juxtahepatic venous injury to major hepatic veins/retrohepatic cava
• D Parenchymal disruption involving 25-75% of hepatic lobe or 1-3 Couinaud segments ✓

Explanation

AAST Grade IV liver injury is defined as parenchymal disruption involving 25-75% of a hepatic lobe or 1-3 Couinaud segments within a single lobe. Grade I is subcapsular haematoma <10% or capsular laceration <1 cm. Grade II involves subcapsular haematoma 10-50% or parenchymal laceration 1-3 cm. Grade III is subcapsular haematoma >50%, expanding, or parenchymal laceration >3 cm. Grade V involves juxtahepatic venous injury. Grade IV/V injuries have high mortality and often require damage control surgery.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.