Splenic laceration - AAST grade IV


Injury to the spleen is usually secondary to blunt trauma.  The arterial vessels of the spleen lack anastomoses and the spleen can be divided into vascular segments, which allows for subtotal splenectomy or splenorraphy.  In this case, there is evidence of laceration extending to the hilum, and devascularization which appears to involve >25% of the spleen in keeping with AAST grade IV splenic injury. The primary goal was to stop active bleeding from the lacerated segmental and trabecular vessels.  After selective embolization, the hemoglobin count of the patient stabilized.