AAST grade | Imaging criteria (CT findings) | Operative criteria | Pathologic criteria |
I | - Subcapsular hematoma <10% surface area
- Parenchymal laceration <1 cm depth
- Capsular tear
| - Subcapsular hematoma <10% surface area
- Parenchymal laceration <1 cm depth
- Capsular tear
| - Subcapsular hematoma <10% surface area
- Parenchymal laceration <1 cm depth
- Capsular tear
|
II | - Subcapsular hematoma 10 to 50% surface area; intraparenchymal hematoma <5 cm
- Parenchymal laceration 1 to 3 cm
| - Subcapsular hematoma 10 to 50% surface area; intraparenchymal hematoma <5 cm
- Parenchymal laceration 1 to 3 cm
| - Subcapsular hematoma 10 to 50% surface area; intraparenchymal hematoma <5 cm
- Parenchymal laceration 1 to 3 cm
|
III | - Subcapsular hematoma >50% surface area; ruptured subcapsular or intraparenchymal hematoma ≥5 cm
- Parenchymal laceration >3 cm depth
| - Subcapsular hematoma >50% surface area or expanding; ruptured subcapsular or intraparenchymal hematoma ≥5 cm
- Parenchymal laceration >3 cm depth
| - Subcapsular hematoma >50% surface area; ruptured subcapsular or intraparenchymal hematoma ≥5 cm
- Parenchymal laceration >3 cm depth
|
IV | - 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
| - Parenchymal laceration involving segmental or hilar vessels producing >25% devascularization
| - Parenchymal laceration involving segmental or hilar vessels producing >25% devascularization
|
V | - Any injury in the presence of splenic vascular injury with active bleeding extending beyond the spleen into the peritoneum
- Shattered spleen
| - Hilar vascular injury that devascularizes the spleen
- Shattered spleen
| - Hilar vascular injury that devascularizes the spleen
- Shattered spleen
|