Wednesday, November 3, 2010

The Liver Injury Scale (LIS) classification

The liver is the largest solid abdominal organ with a relatively fixed position, which makes it prone to injury . Damage to the liver is the most common of death after abdominal injury. The most common cause of liver injury is blunt abdominal trauma, which is secondary to motor vehicle crashes (MVC)

Hepatic injury was graded according to the Hepatic Injury Scale established by the American Association for the Surgery of Trauma (AAST).
This is a liver injury . The injury has been opened to control bleeding branches of the portal and hepatic veins as well as the hepatic arterial radicles. Several biliary ducts were ligated.

Grade and Description of injury
 Grade I : *Haematoma--->Subcapsular, non-expanding, less than 10 percent of surface area
*Laceration--->Capsular tear, non-bleeding, parenchymal depth less than 1 cm

Grade II : *Haematoma--->Subcapsular, non-expanding, 10–50 per cent of surface area or intraparenchymal, non-expanding, less than 2 cm in diameter.
*Laceration--->Capsular tear, active bleeding, parenchymal depth 1–3 cm, less than 10 cm in length.

Grade III : *Haematoma--->Subcapsular, more than 50 per cent of surface area or expanding ruptured subcapsular haematoma with active bleeding intraparenchymal haematoma larger than 2 cm.
*Laceration--->Parenchymal depth more than 3 cm.

Grade VI : *Haematoma--->Ruptured intraparenchymal haematoma with active bleeding.
*Laceration--->Parenchymal disruption of more than 25–50 percent of hepatic lobe.

Grade V : *Laceration--->Parenchymal disruption of more than 50 per cent of hepatic lobe.
*Vascular--->Juxtahepatic venous injuries.

Grade VI : *Vascular--->Hepatic avulsion.

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