Bruised Liver

What is a bruised liver?

A bruised liver is a type of injury to the liver. It is also called a contusion of the liver.

The liver is the largest organ inside your belly. It helps you stay healthy in a number of ways. For example, it helps your body get rid of harmful substances and it makes substances your body needs.

How does it occur?

Car accidents are the most common cause of a liver contusion. For example, the liver can be bruised if your body smashes into the steering wheel. It can also happen when you are playing sports (for example, if you are hit in the belly) or if you fall onto your bicycle handlebars or are in a fight.

What are the symptoms?

The symptoms depend on how the liver was injured and the severity of the injury. A common symptom is pain and tenderness to touch in the area around the liver—that is, the upper right section of the abdomen, including under the right ribs.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and how you were injured. Your provider will examine you and look for injuries such as broken ribs and signs of internal bleeding. He or she will also check to see if the liver is tender or swollen.

An important part of the diagnosis is making sure that the injury is just a contusion and not something more dangerous, such as a tear in the liver or active bleeding from the liver into the abdomen, which can be life-threatening. Blood tests will look for signs of bleeding. Blood tests are also a way to check the functioning of the liver. They may find chemicals (enzymes) that the liver releases into the blood when it is injured.

You may have an ultrasound scan or CT scan. The scans can show swelling of the liver, tears, and collections of blood (hematomas) in the liver. The CT scan can also show other injuries around the liver, such as broken ribs, which can tear the liver or cause bleeding.

How is it treated?

If the physical exam and tests show no evidence of any injury other contusion, the treatment is rest and careful observation. Blood tests may be repeated at least daily for a few days to check for blood loss. The CT scan may also be repeated to make sure that there are no new signs of liver injury or internal bleeding.

How long do the effects last?

Compared with other liver injuries, a contusion tends to be mild and not life threatening. Recovery will depend on how severe the injury was. For example, if the contusion came from a simple fall onto a bicycle handle at low speed, it may only be a matter of days until the soreness is gone and the liver tests are back to normal. If the contusion happened in a bad motor vehicle accident, it may take days to weeks for the liver to return to normal.

How can I take care of myself?

• Follow your healthcare provider’s recommendations for taking care of yourself.
• Keep all your follow-up appointments for lab tests and visits with your provider.
• If your liver blood tests are not normal, your provider may recommend not taking any medicines that might hurt the liver, including nonprescription drugs such as acetaminophen (Tylenol).
• Your provider may tell you to avoid drinking alcohol until your liver is back to normal.
• You may need to limit your activity--possibly even stay in bed--to avoid reinjury of your liver. For example, if you have broken ribs and are too active while the ribs are healing, the ribs could become displaced and reinjure the liver.

How can help prevent a bruised liver?

Because contusions of the liver tend to happen in accidents, there is no easy way to prevent them. Since the many of these injuries are from motor vehicle accidents, wearing your seat belt gives you the best protection.