Splenic injury is classified based on CT findings according to the American Association for the Surgery of Trauma (AAST) Organ Injury Scale. It is a useful scale that categorizes splenic injuries, but it does not predict the need for surgical intervention.
Grade 1
- Hematoma, subcapsular, less than 10% surface area
- Laceration, capsular tear, less than 1 cm parenchymal depth
Grade 2
- Hematoma, subcapsular, 10% to 50% surface area
- Intraparenchymal, less than 5 cm in diameter
- Laceration, capsular tear, 1 cm to 3 cm parenchyma depth that does not involve a trabecular vessel
Grade 3
- Hematoma, subcapsular, more than 50% surface area expanding; ruptured subcapsular or parenchymal hematoma; intraparenchymal hematoma 5 cm or greater and expanding
- Laceration greater than 3 cm parenchymal depth or involving trabecular vessels
Grade 4
- Laceration, laceration involving segmental or hilar vessels producing major devascularization ( more than 25% of the spleen)
Grade 5
- Laceration, completely shattered spleen
- Vascular; a hilar vascular injury that devascularizes the spleen
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References
- Coccolini F, Montori G, Catena F, Kluger Y, Biffl W, Moore EE, Reva V, Bing C, Bala M, Fugazzola P, Bahouth H. Splenic trauma: WSES classification and guidelines for adult and pediatric patients. World Journal of Emergency Surgery. 2017 Dec;12:1-26.
- Knipe H, Murphy A, Botz B, et al. Splenic trauma. Reference article, Radiopaedia.org (Accessed on 16 Mar 2023) https://doi.org/10.53347/rID-26342
- Waseem M, Bjerke S. Splenic injury. InStatPearls [Internet] 2022 Jan 29. StatPearls Publishing.