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Splenic injury refers to trauma-induced damage to the spleen, most commonly from blunt abdominal trauma, making the spleen the most frequently injured solid abdominal organ.
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AAST Splenic Injury Grading (2018 Revision)
| Grade | Description |
|---|---|
| I | Subcapsular hematoma <10% surface, capsular tear <1 cm |
| II | Subcapsular hematoma 10–50%, intraparenchymal <5 cm, laceration 1–3 cm |
| III | Subcapsular hematoma >50% or ruptured, laceration >3 cm |
| IV | Vascular injury (pseudoaneurysm/AV fistula) or laceration involving central vessels with >25% devascularization |
| V | Shattered spleen or active bleeding with peritoneal extension |
Illustration based on the 2018 AAST OIS update: Grading is divided into parenchymal/structural injuries (colour-coded in blue) and vascular injuries (colour-coded in orange). If there are multiple injuries, then the severity of injury should be advanced one grade, up to a maximum of grade III. The overall grading should be defined by the highest grade of injury.
Marmery H, Shanmuganathan K, Alexander MT, Mirvis SE. Optimization of selection for nonoperative management of blunt splenic injury: comparison of MDCT grading systems. American Journal of Roentgenology. 2007;189(6):1421-1427. doi:10.2214/ajr.07.2152 Shi H, Teoh WC, Chin FWK, Tirukonda PS, Cheong SCW, Yiin RSZ. CT of blunt splenic injuries: what the trauma team wants to know from the radiologist. Clinical Radiology. 2019;74(12):903-911. doi:10.1016/j.crad.2019.07.017