Grade
| Injury type | Description of injury
|
|
|
|
I
| Hematoma | Subcapsular, <10% surface area
|
| | |
| Laceration | Capsular tear, <1 cm
parenchymal depth
|
| | |
II
| Hematoma | Subcapsular, 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
| Laceration | Completely 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.
