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What are liver injuries?

The liver is the largest organ inside the body. It sits under the right lower ribs and may go all the way across to the left side. It is soft and can be injured by landing, or being hit, on the right chest or upper abdomen.

Not all liver injuries are the same. Some are minor, involving a small tear in the liver and a small amount of bleeding. Other injuries are severe enough to be life threatening, with tears in the very large blood vessels behind the liver.

How Boston Children's Hospital approaches liver injuries

The Department of Surgery evaluates and treats infants, children, and young adults afflicted with acquired and congenital conditions, including liver injuries, that may require an operation. We strive to improve the quality of life for each child entrusted to our care.

Liver Injuries | Symptoms & Causes

What causes liver injuries?

Accidents involving a motor vehicle(s) are one of the most common causes of liver injuries. Other causes include falls, sports-related incidents, or assaults.

  • pain in the upper right part of the abdomen
  • pain on the right side of the back
  • pain on the top of the right shoulder

Liver Injuries | Diagnosis & Treatments

How are liver injuries diagnosed?

There are many tests that may be done to confirm a liver injury; the most common is a computerized tomogram, or CT scan, of the abdomen. This is a diagnostic procedure that uses a combination of x-rays and computer technology to produce cross-sectional images both horizontally and vertically of the body. A CT scan shows detailed images of any part of the body. It not only shows whether or not the liver is injured, but may say how badly it's injured and if any other internal injuries are present.

Liver injuries may be diagnosed in different ways. Most children with liver injuries have pain in the upper right part of their abdomen, their right back, or on top of their right shoulder. Pressing on or under the right ribs may hurt. With a severe liver injury the child may feel lightheaded, be pale, or have a weak pulse, all findings related to internal bleeding. Children who might have a liver injury should be evaluated immediately by a doctor.

How are liver injuries treated?

In the past, children with a liver injury had an operation to stop the bleeding. Surgeons have learned that 90 percent of children with a liver injury will stop bleeding without an operation. To get the liver to heal, your child needs to remain in bed in the hospital to be sure the liver has stopped bleeding. Then, after your child is discharged from the hospital, participation in sports or other vigorous activities must be restricted for a period of time to prevent any further injury to the liver. Sometimes, if, for example, your child has gone into shock, or the liver doesn't stop bleeding on its own, an operation is urgently needed to repair the liver.

Liver Injuries | Programs & Services