Splenic injury: AAST grade 3

Case contributed by Dr Walid Al-Deeb

Presentation

Slid off motorbike at 30mph. Tender left upper quadrant. Guarding.

Patient Data

Age: 30 years
Gender: Male
Modality: CT

There is an intraparenchymal haematoma/laceration measuring > 5 cm which extends to the splenic hilum. Further splenic laceration noted inferiorly. Trace of perisplenic haematoma and free fluid in the pelvis. The overall appearances are in keeping with a grade 3 splenic injury in accordance with the American Association for the Surgery of Trauma (AAST) splenic injury grading.

No bone fractures or injury to other organs. Chest was clear.

Modality: Diagram

Splenic Injury grading Illustration in accordance with The American Association for the Surgery of Trauma

Case Discussion

Splenic injuries are categorised in accordance with The American Association for the Surgery of Trauma (AAST) splenic injury grading. The following points are used to classify splenic injuries.

  • subcapsular haematoma
  • intraparenchymal haemorrhage
  • laceration depth
  • hilar vascular injury
  • shattered Spleen

Our case was discussed with the local trauma unit and treated conservatively.

Case also contributed by Dr H Godfrey.

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Case Information

rID: 40963
Case created: 9th Nov 2015
Last edited: 22nd May 2017
Tag: trauma
Inclusion in quiz mode: Included

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