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(Hepatic Injury, Bruised Liver)


The liver is an organ that filters your blood. Liver trauma is a direct or piercing injury to the liver.


Trauma to the liver can be caused by a strike or blow such as:

  • Gunshot
  • Knife or any sharp object
  • Blast
  • Motor vehicle accident
  • Falls
  • Attack with or without weapons

Risk Factors

Any direct or piercing injury to the right side of the belly raises your risk. This injury is most common in men and people 15-24 years of age.

They occur most often in:

  • Motor vehicle accidents
  • Violence
  • Falls
  • Accidents at work, such as on farms or in factories


Liver trauma can cause:

  • Bleeding
  • Rapid heartbeat
  • Rapid breathing
  • Cold, wet skin
  • Pale or bluish skin
  • Belly pain and swelling
  • Changes in mental abilities
  • Problems passing urine


You will be asked about your symptoms and past health. You will have a physical exam. Your doctor may suspect an injury based on your exam. Blood tests will show how well your liver is working.

Images will help to show damage inside the body. This can be done with:


Treatment depends on the cause of the injury and how bad it is. Some may heal with rest and time. Your care team will track your progress to make sure you are healing. Your liver function will also be carefully watched.

Other care options include:

  • Blood transfusion—to replace lost blood
  • Angiography—to stop bleeding. A tube is passed through blood vessels in the leg to the liver. There it can block damaged blood vessels and stop bleeding.

Surgery may be needed if the bleeding can’t be stopped.


Accidents cannot always be prevented. To lower your chance of trauma:

  • Always use seat belts.
  • Never drive or use machinery while drinking alcohol or using drugs. Certain medicines can also be risky.
  • Do not use a mobile phone while driving.
  • If you have guns at home, make sure they not loaded. Keep them in a locked place.
  • Use night lights, grab bars, and hand rails to prevent falls.


Family Doctor—American Academy of Family Physicians  https://familydoctor.org 

National Safety Council  https://www.nsc.org 


Canadian Association of Emergency Physicians  http://www.caep.ca 

Trauma Association of Canada  http://www.traumacanada.org 


Hepatic injury. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/home/injuries-and-poisoning/abdominal-injuries/liver-injury. Accessed May 8, 2018.

Liver injuries and home care. UCSF Benioff Children’s Hospital Oakland website. Available at: https://www.childrenshospitaloakland.org/main/liver-injuries.aspx. Accessed May 8, 2018.

Understanding a bruised liver. Saint Luke’s website. Available at: https://www.saintlukeskc.org/health-library/understanding-bruised-liver. Accessed May 8, 2018.

Revision Information