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Spleen: Definitions

American Association for the Surgery of Trauma Spleen Injury Scale

Grade
Injury typeDescription of injury



I
HematomaSubcapsular, <10% surface area
LacerationCapsular tear, <1 cm
parenchymal depth
II
HematomaSubcapsular, 10%-50% surface area
intraparenchymal, <5 cm in diameter
Laceration
Capsular tear, 1-3 cm
Parenchymal depth that does not involve a trabecular vessel

III
Hematoma
Subcapsular, >50% surface area or expanding; ruptured subcapsular or parenchymal hematoma; intraparenchymal hematoma > 5 cm or expanding



Laceration
>3 cm parenchymal depth or involving trabecular vessels


IV
Laceration
Laceration involving segmental or hilar vessels producing major devascularization (>25% of spleen)


V
LacerationCompletely shattered spleen


Vascular
Hilar vascular injury with devascularized spleen


The injury grade can be estimated from the radiology report. The radiologist should report:

  • the presence/absence of hilar involvement,
  • the percentage of splenic parenchymal injury/hematoma (<25%, 25-50%, >50%),
  • The presence of active bleeding, and
  • presence of a pseudoaneurysm
Generally, Grade 1 and 2 injurie are considered low grade injuries while Grade 3-5 are considered high grade injuries.
SOURCE: Spleen: Definitions ( )
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