Liver Laceration: Symptoms & Classification

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 serious. In this lesson, we will learn about classifications of liver lacerations. We will also learn about symptoms of a liver laceration.

There's Been an Accident

It was a beautiful, sunny, warm spring day. Many cars were on the road heading to the lake to enjoy such a great day. Bob and Linda were one of those cars. This was their first trip to the lake this year and they were in good spirits.

They were driving through the last stoplight before leaving the city. When out of nowhere, another car runs a red light and slams into the passenger side door where Linda was seated. Filled with shock, everything was happening so quickly that the next thing Bob and Linda remember was being rushed through the emergency room.

People were buzzing all around Linda and she couldn't keep up with what was happening. She recalls the doctor saying he was concerned that she injured her liver.

Understanding the Liver

Your liver is a large organ in the upper right quadrant of your abdomen. It is one of the most commonly injured organs in abdominal injuries. The most common causes of injury to the liver include motor vehicle accidents, stabbing, or gunshot wounds.

Abdominal Organs
Abdominal organs

You can't live without your liver. Your liver is responsible for metabolizing essentially everything that you put into your body. Blood passes through your liver and it processes nutrients, medications, and toxins that are in your blood stream. It breaks them down and releases them back into your bloodstream to be used by your body. Others are passed along to be eliminated from the body.

Symptoms of a Liver Injury

Thankfully the motor vehicle accident that Bob and Linda were in occurred at a low rate of speed, or their injuries would have been much more severe. When Linda arrived at the emergency room, she surprisingly didn't have any obvious injuries. She was having pain to the right upper part of her abdomen and it was worse when she would take a deep breath. She was also feeling nauseated. The doctor suggested checking blood work and doing a CT scan to determine her injuries.

The most apparent symptom of a liver injury is an abdominal pain in the right, upper quadrant of your abdomen. The pain is worse when you take a deep breath. Other symptoms include nausea and vomiting. Liver injuries result in bleeding and if there is significant blood loss, additional symptoms may be present. These would include feeling lightheaded and having a distended abdomen. Your heart rate may be increased, your pulse may be weak, and your blood pressure may be low.

How to Classify the Severity of a Liver Laceration

The doctor tells Linda that she has a Grade III liver laceration, or tear, from the impact of the car hitting her door. He wants to monitor her closely, but at this time, surgery isn't indicated.

The American Association for the Surgery of Trauma (AAST) has developed classifications for liver injuries to help determine when surgery is indicated. Surgery is not indicated unless the liver injury is a Grade IV or higher. Previously, surgery was indicated for any liver injuries. It was found that a high majority of these had stopped bleeding by the time the surgeon was performing surgery.

Below is the AAST classification of liver lacerations.

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

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