Liver Laceration

A liver laceration is a tear or cut in the liver. Sometimes, this 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 needed.

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 object goes through the skin into the liver (penetrating injury).

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 decide if you have a liver laceration, your caregiver will probably:

  • Do a physical exam. This includes asking about any injuries to the right side of the abdomen.

  • Order some tests, such as:

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

  • Computerized X-ray scan (CT or CAT scan). This test checks for laceration or bleeding.

  • Computerized magnetic scan (MRI). This test can find any bleeding, cuts, or tears.

  • Ultrasound. This test may be used to see if there is blood around the liver.

  • Diagnostic peritoneal lavage. This procedure may be done to check for bleeding in the abdomen. A small cut (incision) is made in the abdomen. A soft tube is put through the incision. A salt water liquid flows through the tube into the abdomen. The fluid is then sucked out. Finally, the fluid is checked to see if it is bloody.

Liver lacerations are categorized in grades from 1 to 5. Low numbers are not as bad as high numbers.

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

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

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

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

TREATMENT

Treatment for a liver laceration will vary. It depends on how deep the cut or tear 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

  • Take all medicines prescribed by your caregiver. Follow the directions carefully.

  • Do not take any over-the-counter painkillers unless your caregiver says it is okay. Some can cause bleeding. This can be very risky for someone who has had a liver laceration.

  • Keep all follow-up appointments.

  • You may need more blood tests or another CT scan.

  • You will probably need to see your caregiver often for about 2 months. These checkups help make sure you are healing well.

  • Take it easy for awhile. It may be several months before you can go back to your old routine. If you have questions about a specific activity, ask before doing it. Until your caregiver says it is okay:

  • Do not do anything that requires extra energy.

  • Do not do any activity that involves much physical contact.

  • Do not do anything risky or dangerous.

  • If you had surgery, you will be given more instructions on what to do and not do. Before leaving the hospital, know how to care for your wound. Ask what to do if a problem develops.

SEEK MEDICAL CARE IF:

  • You have any questions about medicines.

  • Your abdomen still hurts.

  • You feel more weak and tired than usual.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Pain in your abdomen gets much worse.

  • The area around the cut on your skin becomes painful, swells, bleeds, 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.