AAST spleen injury scale

The 1994 revision of the American Association for the Surgery of Trauma (AAST) splenic injury scale is the most widely used grading system for splenic trauma at the time of writing (late 2016). 

Classification

  • grade I
  • grade II
    • subcapsular haematoma 10-50% of surface area
    • intraparenchymal haematoma <5 cm in diameter
    • laceration 1-3 cm in depth not involving trabecular vessels
  • grade III
    • subcapsular haematoma >50% of surface area or expanding
    • intraparenchymal haematoma >5 cm or expanding
    • laceration >3 cm in 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 splenic devascularisation

N.b. advance one grade for multiple injuries up to grade III.

See also


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Article Information

rID: 2074
Synonyms or Alternate Spellings:
  • AAST splenic injury grading system
  • Grading of splenic injury

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Cases and Figures

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    FIgure 1: Splenic trauma grading: diagrams
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    Case 1: grade I
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    Case 2: grade II
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    Case 3: grade III
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    Case 4: grade IV
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    Case 5: grade IV
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    Case 6: grade V
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    Case 7: grade V
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