Abdominal pain after fall.
- Subcapsular hemorrhage of liver
- Intraparenchymal hemorrhage
- Involvement of segment 4a and 4b
Why is Courinaud segment important?
American Association for the Surgery of Trauma (AAST) system (based on CT findings)
– Grade I-III: Conservative management, better prognosis than higher grades
– Grade IV-VI: Endovascular intervention (embolization) or surgery usually required, worse prognosis
The key is whether this is
- a capsular tear (superficial): Grade I-III or
- intraparenchymal rupture (deep) with involvement of >1 segments or hepatic lobes: Grade IV and later
Referenc: radiopaedia.org, http://www.auntieminnie.com