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UVM Radiology

Splenic Injury AAST Grading System

The Organ Injury Scaling Committee of the American Association for the Surgery of Trauma was organized to devise universal grading systems for individual organs.

The spleen injury grading scale is as follows:

  • Grade I - Subcapsular hematoma of less than 10% of surface area. Capsular tear of less than 1 cm in depth
  • Grade II - Subcapsular hematoma of 10-50% of surface area. Intraparenchymal hematoma of less than 5 cm in diameter. Laceration of 1-3 cm in depth and not involving trabecular vessels.
  • Grade III - Subcapsular hematoma of greater than 50% of surface area or expanding and ruptured subcapsular or parenchymal hematoma. Intraparenchymal hematoma of greater than 5 cm or expanding. Laceration of greater than 3 cm in depth or involving trabecular vessels
  • Grade IV - Laceration involving segmental or hilar vessels with devascularization of more than 25% of the spleen
  • Grade V - Shattered spleen or hilar vascular injury

Advance one grade for multiple injuries up to grade III.


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