Liver Laceration Grading

Grade 1
  • capsular laceration < 1cm deep
  • subcapsular hematoma < 10% of liver
Grade 2
  • capsular laceration 1-3cm deep or < 10cm length
  • subcapsular hematoma 10-50 % surface area
  • intraparenchymal hematoma < 10cm diameter
Grade 3
  • laceration > 3cm deep
  • subcapsular hematoma > 50% surface area
  • intraparenchymal hematoma > 10cm or expanding
Grade 4
  • laceration of 25-75% of hepatic lobe or 1-3 Couinaud segments
Grade 5
  • disruption of >75% of hepatic lobe or > 3 Couinaud segments in a single lobe
  • juxtahepatic vascular injury (ex retrohepatic cava, major central hepatic veins)
Grade 6
  • hepatic avulsion