AAST spleen injury scale
Updates to Article Attributes
Body
was changed:
The 2018 revision of the American Association for the Surgery of Trauma (AAST) splenic injury scale is, most recently revised in 2018, is currently the most widely used grading system for splenic trauma.
The following is2018 update incorporates "vascular injury" (i.e. pseudoaneurysm, arteriovenous fistula) into the imaging criteria for classification based on CT findingsvisceral injury 4.
Classification
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grade I
- subcapsular haematoma <10% of surface area
- parenchymal laceration <1 cm depth
- capsular tear
-
grade II
- subcapsular haematoma 10-50% of surface area
- intraparenchymal haematoma <5 cm
- parenchymal laceration 1-3 cm in depth
-
grade III
- subcapsular haematoma >50% of surface area
- ruptured subcapsular or intraparenchymal haematoma ≥5 cm
- parenchymal laceration >3 cm in depth
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grade 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% devascularisation
-
grade V
- shattered spleen
- any injury in the presence of splenic vascular injury* with active bleeding extending beyond the spleen into the peritoneum
N.b.
Additional points
- advance one grade for multiple injuries up to grade III
.More than one grade of -
"vascular injury
may be present and should be classified as the higher grade" (i.e.*Vascular injury refers to athat) - appears as a focal collection of vascular contrast,which decreases in attenuation on delayed images -
"active bleeding" - focal or diffuse
, andcollection of vascular contrast which increases in size or attenuationinon a delayed phase
Imaging Technique
The AAST guidelines recommend dual arterial/portal venous phase imaging for evaluation of vascular injury of liver, spleen, or kidney 4.
See also
-<p>The 2018 revision of the <strong>American Association for the Surgery of Trauma (AAST)</strong> <strong>splenic injury scale</strong> is currently the most widely used grading system for <a href="/articles/splenic-trauma">splenic trauma</a>. The following is the imaging criteria for classification based on CT findings.</p><h4>Classification</h4><ul>- +<p>The <strong>American Association for the Surgery of Trauma (AAST)</strong> <strong>splenic injury scale</strong>, most recently revised in 2018, is currently the most widely used grading system for <a href="/articles/splenic-trauma">splenic trauma</a>.</p><p>The 2018 update incorporates "vascular injury" (i.e. <a href="/articles/false-aneurysm">pseudoaneurysm</a>, <a href="/articles/arteriovenous-fistula">arteriovenous fistula</a>) into the imaging criteria for visceral injury <sup>4</sup>.</p><h4>Classification</h4><ul>
-</ul><p>N.b. advance one grade for multiple injuries up to grade III.</p><p>More than one grade of injury may be present and should be classified as the higher grade.</p><p>*Vascular injury refers to a pseudoaneurysm or AV fistula that appears as a focal collection of vascular contrast, focal or diffuse, and increases in size or attenuation in delayed phase.</p><h4>See also</h4><ul>- +</ul><h5>Additional points</h5><ul>
- +<li>advance one grade for multiple injuries up to grade III</li>
- +<li>"vascular injury" (i.e. pseudoaneurysm or AV fistula) - appears as a focal collection of vascular contrast which decreases in attenuation on delayed images</li>
- +<li>"active bleeding" - focal or diffuse collection of vascular contrast which increases in size or attenuation on a delayed phase</li>
- +</ul><h4>Imaging Technique</h4><p>The AAST guidelines recommend dual arterial/portal venous phase imaging for evaluation of vascular injury of liver, spleen, or kidney <sup>4</sup>.</p><h4>See also</h4><ul>
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