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e-CASES: Liver injuries: AAST organ injury scale

Dr Antoine Micheau , CHU Arnaud de Villeneuve , Montpellier , Herault , France

Grade I

Hematoma :Subcapsular, nonexpanding, <10% surface area

Laceration: Capsular tear, nonbleeding, <1cm parenchymal depth


Grade II

Hematoma: Subcapsular, nonexpanding, 10-50% surface area - Intraparenchymal, <2cm diameter, nonexpanding

Laceration: Capsular tear, active bleeding, 1-3cm parenchymal depth


Grade III

Hematoma: Subcapsular, >50% surface area or expanding - Ruptured subcapsular hematoma with active bleeding - Intraparenchymal, >2cm diameter or expanding

Laceration : > 3 cm parenchymal depth


Grade IV

Hematoma: Ruptured intraparenchymal hematoma with active bleeding

Laceration: Involving segmental or hilar vessels producing devascularization >25%


Grade V

Laceration: Shattered spleen

Vascular: Hilar vascular injury that devascularizes spleen

! Advance one grade for multiple injuries to same organ up to grade III