title: Liver injury following blunt abdominal trauma: a new mechanism-driven classification.
abstract: OBJECTIVE
  The current classifications for blunt liver trauma focus only on the extent of liver injury. However, these scores are independent from the localization of liver injury and mechanism of trauma.
  
  
  METHODS
  The type of liver injury after blunt abdominal trauma was newly classified as type A when it was along the falciform ligament with involvement of segments IVa/b, III, or II, and type B when there was involvement of segments V-VIII. With the use of a prospectively established database, the clinical, perioperative, and outcome data were analyzed regarding the trauma mechanism, as well as the radiological and intraoperative findings.
  
  
  RESULTS
  In 64 patients, the type of liver injury following blunt abdominal trauma was clearly linked with the mechanism of trauma: type A injuries (n = 28) were associated with a frontal trauma, whereas type B injuries (n = 36) were found after complex trauma mechanisms. The demographic data, mortality, ICU stay, and hospital stay showed no significant differences between the two groups. Interestingly, all patients with type A ruptures required immediate surgical intervention, whereas six patients (16.7 %) with type B ruptures could be managed conservatively.
  
  
  CONCLUSIONS
  This new classification for blunt traumatic hepatic injury is based on the localization of parenchymal disruption and correlates with the mechanism of trauma. The type of liver injury correlated with the necessity for surgical therapy.
authors: Department of General Surgery, Visceral, Vascular and Paediatric Surgery, University of Saarland, Homburg/Saar, 66421, Saarland, Germany, msc.slottaje@googlemail.com.
authors: J E
authors: JE
authors: Slotta
authors: C
authors: C
authors: Justinger
authors: O
authors: O
authors: Kollmar
authors: C
authors: C
authors: Kollmar
authors: T
authors: T
authors: Schäfer
authors: M K
authors: MK
authors: Schilling
mesh_terms: D000007:Abdominal Injuries / Q000145:classification*; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008297:Male; D012421:Rupture; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000145:classification*