Grade 4<unk>  laceration Imaging, such as the use of ultrasound or a computed tomography scan, is the generally preferred way of diagnosis as it is more accurate and is sensitive to bleeding, however; due to logistics this is not always possible. For a person who is hemodynamically unstable a focused assessment with sonography for trauma (FAST) scan may take place which is used to find free floating fluid in the right upper quadrant and left lower quadrant of the abdomen. The FAST scan however may not be indicated in those who are obese and those with subcutaneous emphysema. Its speed and sensitivity to<unk> es resulting in 400mL of free-floating fluid make it a valuable tool in the evaluation of unstable persons. Computed tomography is another diagnostic study which can be performed, but typically is only used in those who are hemodynamically stable. A physical examination may be used but is typically inaccurate in blunt trauma, unlike in penetrating trauma where the trajectory the projectile took can be followed digitally. A diagnostic peritoneal lavage (DPL) may also be utilized but has limited application as it is hard to determine the origin of the bleeding. A diagnostic peritoneal lavage is generally discouraged when FAST is available as it is invasive and non-specific. Classification + The<unk>  Scale classification Grade Subcapsular hematoma Laceration I 50% or >10 cm >3 cm IV 25–75% of a hepatic lobe V >75% of a hepatic lobe VI Hepatic avulsion<unk> es are classified on a Roman numeral scale with I being the least severe, to VI being the most severe. Generally any<unk>  ≥III requires surgery.
Liver injury
Hepatotoxicity
Neurotoxicity
Lipotoxicity
Pulmonary toxicity
Nephrotoxicity
Phototoxicity
Cardiotoxicity