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. 2020 Dec 5;16:106–113. doi: 10.1016/j.jcot.2020.12.006

Table 5.

Sample of ATLS organ injury scoring - Recent modified liver injury scoring:34.

Grade I Grade II Grade III Grade IV Grade V
  • 1

    Hematoma: subcapsular, <10% surface area

  • 2

    Laceration: capsular tear, <1 cm parenchymal depth
  • 1

    Hematoma: subcapsular, 10–50% surface area

  • 2

    Hematoma: intraparenchymal <10 cm diameter

  • 3

    Laceration: capsular tear 1–3 cm, parenchymal depth, <10 cm length
  • 1

    Hematoma: subcapsular, >50% surface area of ruptured subcapsular or parenchymal hematoma

  • 2

    Hematoma: intraparenchymal >10 cm

  • 3

    Laceration: capsular tear >3 cm, parenchymal depth

  • 4.

    Vascular injury with active bleeding contained within liver parenchyma
  • 1

    Laceration: parenchymal disruption involving 25–75% hepatic lobe or involves 1–3 Couinaud segments

  • 2.

    Vascular injury with active bleeding breaching the liver parenchyma into the peritoneum
  • 1

    Laceration: parenchymal disruption involving >75% of hepatic lobe.

  • 2

    Vascular: juxtahepatic venous injuries (retrohepatic vena cava/central major hepatic veins)

  • 3

    Additional points: advance one grade for multiple injuries up to grade III, “vascular injury” (i.e. pseudoaneurysm or AV fistula) - appears as a focal collection of vascular contrast which decreases in attenuation on delayed images “active bleeding” - focal or diffuse collection of vascular contrast which increases in size or attenuation on a delayed phase.