Liver Injury Grading System

Grade I-

Hematoma- Subcapsular < 10% of surface area.

Laceration- Capsular tear < 1 cm in depth.

Grade II-

Subcapsular 10- 50% surface area
Intraparenchymal < 10 cm in diameter.

Laceration- 1-3 cm in depth or <10 cm in length.

Grade III-

Subcapsular < 50% surface area or expanding or ruptured subcapsular hematoma with active bleeding.
Intraparenchymal > 10 cm or expanding or ruptured.

Laceration > 3 cm in depth.

Grade IV-

Hematoma- Ruptured intraparenchymal hematoma with active bleeding.

Laceration- Parenchymal disruption involving 25- 75% of a hepatic lobe.

Grade V-

Laceration. Parenchymal disruption involving > 75% of a hepatic lobe.

Vascular- Juxtahepatic venous injuries (IVC or central hepatic veins).

Grade VI-

Hepatic avulsion.