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Non-operative management versus operative management in high-grade blunt hepatic injury

  1. Eleonora Pressi1,
  2. Roberto Cirocchi2,
  3. Eriberto Farinella3,
  4. Stefano Trastulli2,
  5. Luis M Barrera4,*,
  6. Carlos Hernando Morales Uribe4,
  7. Ana Maria Botero4

Editorial Group: Cochrane Injuries Group

Published Online: 21 FEB 2014

DOI: 10.1002/14651858.CD010989


How to Cite

Pressi E, Cirocchi R, Farinella E, Trastulli S, Barrera LM, Morales Uribe CH, Botero AM. Non-operative management versus operative management in high-grade blunt hepatic injury (Protocol). Cochrane Database of Systematic Reviews 2014, Issue 2. Art. No.: CD010989. DOI: 10.1002/14651858.CD010989.

Author Information

  1. 1

    Liver Unit and Department of Digestive Surgery, Hospital of Terni, Terni, Italy

  2. 2

    University of Perugia, Department of General Surgery, Terni, Italy

  3. 3

    Chelsea and Westminster Hospital NHS Foundation Trust, General and Colorectal Surgery, London, UK

  4. 4

    Universidad de Antioquia, Department of General Surgery, Medellín, Colombia

*Luis M Barrera, Department of General Surgery, Universidad de Antioquia, Street 67 N 53-108, Medellín, Colombia. luismanuelbarrera@gmail.com. bluis73@hotmail.com.

Publication History

  1. Publication Status: New
  2. Published Online: 21 FEB 2014

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Table 1. AAST revised the Hepatic Injury Scale

Grade*Type of injuryDescription of injury

IHaematomaSubcapsular, < 10% surface area

LacerationCapsular tear, < 1 cm parenchymal depth

IIHaematomaSubcapsular, 10% to 50% surface area or intraparenchymal, < 10 cm in diameter

Laceration1 to 3 cm parenchymal depth, less than 10 cm in length

IIIHaematomaSubcapsular, > 50% surface area, expanding ruptured subcapsular or parenchymal haematoma with active bleeding, or intraparenchymal haematoma > 10 cm or expanding

Laceration> 3 cm depth

IVLacerationParenchymal disruption involving 25% to 75% of hepatic lobe or 1 to 3 Couinaud segments within a single lobe

VLacerationParenchymal disruption involving > 75% of hepatic lobe or more than 3 Couinaud segments within a single lobe

VascularJuxtahepatic venous injuries, i.e. retrohepatic vena cava/major hepatic veins

VIVascularHepatic avulsion

*Advance 1 grade for multiple injuries.

*Quoted from Moore (Moore 1995) and others.