Title: Splenic Injury Grades<br/>Author: Robert Flint<br/><a href='http://umem.org/profiles/faculty/2561/'>[Click to email author]</a><hr/><p>    </p>  <p>   <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Splenic injury treatment depends on the grade of injury. In general, grades 1 and 2 are non-operatively managed. Grades 4 and 5 tend to be managed operatively. Interventional radiology is used commonly for grade 3 and grades 1 and 2 if active contrast extravasation is seen.  Below is a refresher on splenic injury grading.</span></span></p>  <p>    </p>  <p>    </p>  <p>   <strong>Table 1</strong></p>  <p>   <strong>Adaptation of AAST Organ Injury Scale for Spleen</strong></p>  <table border="0" cellpadding="0" cellspacing="0" style="width:951px;" width="713">   <thead>    <tr>     <th>      <p>       Grade </p>     </th>     <th>      <p>       Injury type</p>     </th>     <th>      <p>       Description of injury</p>     </th>    </tr>   </thead>   <tbody>    <tr>     <td>      <p>       I</p>     </td>     <td>      <p>       Hematoma<br />       Laceration</p>     </td>     <td>      <p>       Subcapsular, <10% surface area<br />       Capsular tear, <1 cm parenchymal depth</p>     </td>    </tr>    <tr>     <td rowspan="2">      <p>       II</p>     </td>     <td>      <p>       Hematoma</p>     </td>     <td>      <p>       Subcapsular, 10% to 50% surface area<br />       Intraparenchymal, <5 cm in diameter</p>     </td>    </tr>    <tr>     <td>      <p>       Laceration</p>     </td>     <td>      <p>       Capsular tear, 1 cm to 3 cm parenchymal depth that does not involve a trabecular vessel</p>     </td>    </tr>    <tr>     <td>      <p>       III</p>     </td>     <td>      <p>       Hematoma<br />       Laceration </p>     </td>     <td>      <p>       Subcapsular, >50% surface are or expanding: ruptured subcapsular or parenchymal hematoma: intraparenchymal hematoma_>5 cm or expanding<br />       3 cm parenchymal depth or involving trabecular vessels</p>     </td>    </tr>    <tr>     <td>      <p>       IV</p>     </td>     <td>      <p>       Laceration</p>     </td>     <td>      <p>       Laceration involving segmental or hilar vessels producing major devascularization (>25% of spleen)</p>     </td>    </tr>    <tr>     <td>      <p>       V</p>     </td>     <td>      <p>       Laceration<br />       Vascular</p>     </td>     <td>      <p>       Completely shattered spleen<br />       Hilar vascular injury with devascularizes spleen </p>     </td>    </tr>   </tbody>  </table>  <ul>   <li>    Adapted from American Association for the Surgery of Trauma organ injury scale for spleen.<img alt="" src="https://umem.org/files/uploads/content/FLINT/spleen.png" style="width: 607px; height: 948px;" /></li>  </ul>  <fieldset><legend>References</legend>

                <p>   1. An update on nonoperative management of the spleen in adults. BMJ Trauma Surgery and Acute Care Open. Volume 2, Issue 1.  Ben L Zarzaur, Grace S Rozycki</p>  <p>   2. https://www.google.com/search?q=splenic+laceration+grading&rlz=1C9BKJA_enUS1063US1063&oq=splenic+laceration+grading&aqs=chrome..69i57j0i512l3j0i22i30l6.9531j0j4&hl=en-US&sourceid=chrome-mobile&ie=UTF-8#vhid=0ARTxhEO89dgGM&vssid=l</p>  </fieldset>