AAST Liver Injury

Question 1

Grade I

Answer 1

Haematoma: subcapsular, <10% surface area

Laceration: capsular tear, <1 cm parenchymal depth

Question 2

Grade II

Answer 2

Haematoma: subcapsular, 10-50% surface area

Haematoma: intraparenchymal <10 cm diameter

Laceration: capsular tear 1-3 cm parenchymal depth, <10 cm length

Question 3

Grade III

Answer 3

Haematoma: subcapsular, >50% surface area of ruptured subcapsular or parenchymal haematoma

Haematoma: intraparenchymal >10 cm

Laceration: capsular tear >3 cm parenchymal depth

Vascular injury with active bleeding contained within liver parenchyma

Question 4

Grade IV

Answer 4

Laceration: parenchymal disruption involving 25-75% hepatic lobe or involves 1-3 Couinaud segments

Vascular injury with active bleeding breaching the liver parenchyma into the peritoneum

Question 5

Grade V

Answer 5

Laceration: parenchymal disruption involving >75% of hepatic lobe

Vascular injury: juxtahepatic venous injuries (retrohepatic vena cava / central major hepatic veins