Splenic trauma injury grading

The American Association for the Surgery of Trauma (AAST) splenic injury grading system is as follows:

  • grade I
  • grade II
    • subcapsular haematoma 10-50% of surface area
    • intraparenchymal haematoma <5 cm in diameter
    • laceration 1-3 cm depth not involving trabecular vessels
  • grade III
    • subcapsular haematoma >50% of surface area or expanding
    • intraparenchymal haematoma >5 cm or expanding
    • laceration >3 cm depth or involving trabecular vessels
    • ruptured subcapsular or parenchymal haematoma
  • grade IV
    • laceration involving segmental or hilar vessels with major devascularisation (>25% of spleen)
  • grade V
    • shattered spleen
    • hilar vascular injury with devascularised spleen

NB Advance one grade for multiple injuries up to grade III

See also


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