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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