WSES classification and guidelines for liver trauma

Table 2 WSES Liver Trauma Classification

	WSES grade	Blunt/Penetrating (Stab/Guns)	AAST	Haemodynamic	CT-scan	First-line Treatment
MINOR	WSES grade I	B/P SW/GSW	I-II	Stable
MODERATE	WSES grade II	B/P SW/GSW	III	Stable	Yes + Local Exploration in SW#	NOM* + Serial Clinical/Laboratory/ Radiological Evaluation
SEVERE	WSES grade III	B/P SW/GSW	IV-V	Stable
SEVERE	WSES grade IV	B/P SW/GSW	I-VI	Unstable	No	OM

(SW Stab Wound, GSW Gun Shot Wound; OM: Operative Management; NOM: Non Operative Management; *NOM should only be attempted in centers capable of a precise diagnosis of the severity of liver injuries and capable of intensive management (close clinical observation and haemodynamic monitoring in a high dependency/intensive care environment, including serial clinical examination and laboratory assay, with immediate access to diagnostics, interventional radiology and surgery and immediately available access to blood and blood products; # wound exploration near the inferior costal margin should be avoided if not strictly necessary because of the high risk to damage the intercostal vessels)

ISSN: 1749-7922