Spleen Injury Grading Scale

The Organ Injury Scaling (OIS) Committee’s classification of spleen trauma:

Grade I
Haematoma: Subcapsular, <10 surface area
Laceration: Capsular tear, <1cm parenchymal depth

Grade II
Haematoma: Subcapsular, 10-50 surface area; Intraparenchymal, <5cm diameter
Laceration: Laceration 1-3cm parenchymal depth not involving a parenchymal vessel

Grade III
Haematoma: Subcapsular, >50 surface area or expanding.
Laceration: Ruptured subcapsular or parenchymal haematoma; Intraparencymal haematoma >5cm

Grade IV
Laceration: >3cm parenchymal depth or involving trabecular vessels; Laceration of segmental or hilar vessels producing major devascularization (>25% of the spleen)

Grade V
Laceration: Completely shattered spleen
Vascular: Hilar vascular injury which devascularized the spleen

Advance one grade for multiple injuries to same organ up to Grade III.

Reference

Moore EE, Cogbill TH, Malangoni MA, Jurkovich GJ, Shackford SR, Champion HR, McAninch JW. Organ injury scaling. Surg Clin North Am 1995; 75: 293-303.