Splenic injuries

Diagnosis

Splenic injuries

History

AAST Spleen Injury Scale 2018 revision

grade I

• subcapsular hematoma <10% of surface area
• parenchymal laceration <1 cm depth
• capsular tear

grade II

• subcapsular hematoma 10-50% of surface area
• intraparenchymal hematoma <5 cm
• parenchymal laceration 1-3 cm in depth

grade III

• subcapsular hematoma >50% of surface area
• ruptured subcapsular or intraparenchymal hematoma ≥5 cm
• parenchymal laceration >3 cm in depth

grade IV

• any injury in the presence of a splenic vascular injury or active bleeding confined within splenic capsule
• parenchymal laceration involving segmental or hilar vessels producing >25% devascularisation

grade V

• shattered spleen
• any injury in the presence of splenic vascular injury with active bleeding extending beyond the spleen into the peritoneum