Liver Laceration: Complications & Treatment

Instructor: Justine Fritzel

Justine has been a Registered Nurse for 10 years and has a Bachelor's of Science in Nursing degree.

An injury to your liver can be life threatening. In this lesson, we will learn about complications from liver lacerations. We will also learn what treatment is indicated for liver injuries.

The Amazing Work of Your Liver

Your liver is the largest, solid organ in your abdominal cavity. Almost all the blood in your body passes through your liver. At any given time, one pint of blood is in your liver. Nutrients from what you ate for breakfast are broken down to be used by your body. The medications you took are carried through your liver where they are metabolized to be effective. And that beer that you drank last night passes through your liver to be filtered and eliminated from your body. The liver is like the filter of your body.

Abdominal Organs
abdominal organs

Even when there is damage to your liver, it can regenerate itself to some degree. But without a functioning liver, you won't live.

Liver Injuries

Due to its size and location, it is unfortunately one of the most commonly injured organs in abdominal injuries. A liver laceration is a tear to your liver. The most common cause of liver lacerations include motor vehicle accidents, gunshot wounds, or stabbing wounds.

Liver injuries are rated on their severity using the American Association of Surgery for trauma (AAST) liver injury classification scale. The AAST liver injury classification scale has six grades and is included below.

Grade I is a tear that is less than 1 cm deep

Grade II is a tear that is 1-3 cm deep and less than 10 cm in length

Grade III is a tear that is greater than 3 cm deep

Grade IV is when the liver laceration involves 25-75% of a liver lobe or 1-3 segments within a lobe

Grade V involves more than 75% of a lobe or more than three segments within a lobe

Grade VI is hepatic avulsion which is when part of the liver is severed.

Complications of Liver Lacerations

As we learned earlier, almost all of your blood passes through your liver, and at any given time there is a total of one pint of blood within your liver. This helps you understand why a liver laceration can result in bleeding. Depending on the severity of the laceration, the blood loss can be significant and life threatening.

Delayed bleeding and rebleeding from a liver laceration are both complications that can occur. Additional complications can include leaking bile, abcesses within the liver, cholecystitis, which is inflammation of the gallbladder, or even liver failure.

Treatment of Liver Injuries

Historically, surgery was indicated for most liver lacerations. Research, however, found that a high majority of these injuries had actually stopped bleeding before the surgeon was operating. Now the current practice is for more of a nonoperative approach. Depending on the AAST liver injury classification, your blood levels will be monitored while your liver is healing.

Your doctor may require you to be on bedrest to avoid any further tearing to your liver injury and to prevent any more bleeding. You will be on a lifting restriction and should not participate in any sports. You should not take any medications that may increase your likelihood of bleeding, such as aspirin.

Surgery is indicated for liver injuries Grade IV and greater to help stop the bleeding. Liver lacerations can be life threatening, so it is important to follow your doctor's recommendations to avoid further injury.

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