Note: Illustration not yet up to date.

Classification Description Notes
Grade 1 – Subcapsular hematoma <10% surface area

– Parenchymal laceration <1 cm depth

– Capsular tear

Grade 2 –Hematoma: Subcapsular, 10-50% surface area

– Subcapsular hematoma 10–50% surface area; intraparenchymal hematoma <5 cm

– Parenchymal laceration 1–3 cm

Grade 3
– Subcapsular hematoma >50% surface area; ruptured subcapsular or intraparenchymal hematoma ≥5 cm

– Parenchymal laceration >3 cm depth

Grade 4 – Any injury in the presence of a splenic vascular injury or active bleeding confined within splenic capsule

– Parenchymal laceration involving segmental or hilar vessels producing >25% devascularization

Grade 5 – Any injury in the presence of splenic vascular injury with active bleeding extending beyond the spleen into the peritoneum

Note: Advance one grade for multiple splenic injuries up to grade 3.

 

Reference:

Kozar RA et al. (2018). Organ injury scaling 2018 update: Spleen, liver, and kidney. J Trauma Acute Care Surg; 85(6):1119- 1122