Splenic Injury Grading
AAST Splenic Injury Scale 2018
Classification | Description | Notes |
Grade 1 | – Subcapsular hematoma <10% surface area – Parenchymal laceration <1 cm depth – Capsular tear | |
Grade 2 | –Hematoma: Subcapsular, 10-50% surface area
– Subcapsular hematoma 10–50% surface area; intraparenchymal hematoma <5 cm – Parenchymal laceration 1–3 cm | |
Grade 3 | – Subcapsular hematoma >50% surface area; ruptured subcapsular or intraparenchymal hematoma ≥5 cm
– Parenchymal laceration >3 cm depth | |
Grade 4 | – 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% devascularization | |
Grade 5 | – Any injury in the presence of splenic vascular injury with active bleeding extending beyond the spleen into the peritoneum |
Note: Advance one grade for multiple splenic injuries up to grade 3.