•Largest solid abdominal organ,fixed position
•Second most common injured, but most
common cause of death after abdominal
•Blunt MVA most common
•80% adults, 97% children-conservative rx
•Friable parenchyma, thin capsule, fixed
position in relation to spine.
•Right lobe gets hit more since its larger, and
closer to ribs.
•85% injuries involve segments 6,7,8 from
compressioin against ribs, spine, abd wall.
•Shear forces at attachments to diaphragm
•Transmission thru right hemithorax.
•Liver injured easily in children since ribs are
compliant, force transmitted.
•Liver not as developed in children, with
weaker connective tissue framework.
•Iatrogenic injuries by biopsies, biliary
drainage, TIPS, can cause capsular tears and
bile leaks, fistulas, hemoperitoneum.