Liver Laceration

A liver laceration is a tear or cut in the liver. The liver is the largest solid organ in the body and is involved in many important bodily functions. Sometimes, a liver laceration can be a very serious injury. It can cause a lot of bleeding. Surgery may be needed. Other times, a liver laceration may be minor. Bed rest may be all that is needed. Either way, treatment in a hospital is almost always required.

Liver lacerations are categorized in grades from 1 to 5. Low numbers identify lacerations that are less severe than those with high numbers.

  • Grade 1: This is a tear in the outer lining of the liver. It is less than ½ inch (1 cm) deep.  

  • Grade 2: This is a tear that is about ½ inch to 1 inch (1 to 3 cm) deep. It is less than 4 inches (10 cm) long.  

  • Grade 3: This is a tear that is slightly more than 1 inch (3 cm) deep.  

  • Grades 4 and 5: These lacerations are very deep. They affect a large part of the liver.  

CAUSES

  • A strong blow to the area around your liver (blunt trauma). Blunt trauma can tear the liver even though it does not break the skin.

  • An injury in which an object goes through the skin into the liver (penetrating injury).

SIGNS AND SYMPTOMS

The most common symptoms of liver laceration are:

  • A swollen and firm abdomen.  

  • Pain in the abdomen.  

  • Tenderness when pressing on the right side of the abdomen.  

Other symptoms may include:

  • Bleeding from a penetrating wound.  

  • Spitting up blood.  

  • Bruises on the abdomen.  

  • A fast heartbeat.  

  • Taking quick breaths.  

  • Feeling weak and dizzy.  

DIAGNOSIS

To determine if you have a liver laceration, your health care provider will perform a physical exam and ask about any injuries to the right side of the abdomen. Various tests may be ordered, such as:

  • Blood tests. Your blood may be tested every few hours. This will show if you are losing blood.  

  • CT scan. This test is used to check for laceration or bleeding.

  • Laparoscopy. This involves placing a small camera into the abdomen and looking directly at the surface of the liver. 

TREATMENT

Treatment for a liver laceration will vary depending on how deep the cut is and on the amount of bleeding. Treatment options include:

  • Bed rest. The person is watched closely. Tests are done very often.  

  • Blood transfusions. Blood is given from someone else. This replaces blood lost from the injury. A transfusion may need to be done several times.  

  • Surgery. A procedure may be needed to open the abdomen. Then, special material might be packed around the laceration to help it heal, or the laceration might be repaired.

HOME CARE INSTRUCTIONS

  • Only take over-the-counter or prescription medicines as directed by your health care provider. Take all prescribed medicines exactly as directed. Do not take any other medicines without first asking your health care provider.

  • Rest and limit your activity as directed by your health care provider. It may be several months before you can go back to your old routine. Do not participate in activities that involve physical contact or require extra energy until your health care provider approves.

  • Keep all follow-up appointments with your health care provider. You may need more blood tests or another CT scan to make sure your injury is healing.

SEEK MEDICAL CARE IF:

  • Your abdominal pain does not go away.  

  • You feel more weak and tired than usual.  

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your abdominal pain gets worse.  

  • You have a cut or incision on your skin that becomes red, swells, or leaks any fluid.  

  • You feel dizzy or very weak.  

  • You have trouble breathing.  

  • You have a fever.  

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.