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Classification Description Notes
Grade 1 – Subcapsular hematoma <10% surface area

– Parenchymal laceration <1 cm in depth

 
Grade 2 – Subcapsular hematoma 10–50% surface area; intraparenchymal hematoma <10 cm in diameter

– Laceration 1–3 cmin depth and ≤ 10 cm length

 
Grade 3 – Subcapsular hematoma >50% surface area; ruptured subcapsular or parenchymal hematoma

– Intraparenchymal hematoma >10 cm

– Laceration >3 cm depth

– Any injury in the presence of a liver vascular injury or active bleeding contained within liver parenchyma

 
Grade 4 – Parenchymal disruption involving 25–75% of a hepatic lobe

– Active bleeding extending beyond the liver parenchyma into the peritoneum

 
Grade 5 – Parenchymal disruption >75% of hepatic lobe

– Juxtahepatic venous injury to include retrohepatic vena cava and central major hepatic veins

 

Note: Advance one grade for multiple hepatic injuries up to grade 3.

 

 

Reference:

Trauma Acute Care Surg; 85(6):1119- 1122