Liver trauma classification

Abstract

The present paper analyses the issue of liver trauma classification. Liver trauma classification is useful for many reasons and in particular because it establishes a common ground of communication with other specializations. The most significant attempts to classify liver trauma are presented, i.e. a) liver trauma classification according to the trauma mechanism. b) liver trauma classification based on anatomical segmentation according to Couinaud [1] and the surgery required [2] proposed in 1990. c) liver trauma classification based on vascular damage [3] proposed in 1994, and d) imaging classification of liver trauma proposed by Mirvis et al in 1989 [4]. The paper focuses in particular on the detailed presentation of the classification proposed by Moore et al in 1989 [5], as revised in 1994 by the American Association for the Surgery of Trauma (AAST). This classification is based on anatomical criteria that define the precise damage to the hepatic parenchyma and includes six grades of injury that are presented in detail. The paper concludes that the classification proposed by Moore et al, as revised in 1994 by the AAST, meets most of the criteria for a correct classification system making it today the most accepted and most common point of reference for all surgeons.