Grading Solid Organ Injury

Spleen injury scale (1994 revision)
Grade*	Injury type	Description of injury
I	Hematoma	Subcapsular, <10% surface area
	Laceration	Capsular tear, <1cm
		parenchymal depth
II	Hematoma	Subcapsular, 10%-50% surface area
		intraparenchymal, <5 cm in diameter
	Laceration	Capsular tear, 1-3cm parenchymal depth that does not
		involve a trabecular vessel
III	Hematoma	Subcapsular, >50% surface area or expanding; ruptured
		subcapsular or parecymal hematoma; intraparenchymal
		hematoma > 5 cm or expanding
	Laceration	>3 cm parenchymal depth or involving trabecular vessels
IV	Laceration	Laceration involving segmental or hilar vessels producing
		major devascularization (>25% of spleen)
V	Laceration	Completely shattered spleen
	Vascular	Hilar vascular injury with devascularizes spleen
*Advance one grade for multiple injuries up to grade III.

Liver injury scale (1994 revision)
Grade*	Injury type	Description of injury
I	Hematoma	Subcapsular, <10% surface area
	Laceration	Capsular tear, <1cm
		parenchymal depth
II	Hematoma	Subcapsular, 10% to 50% surface area
		intraparenchymal <10 cm in diameter
	Laceration	Capsular tear 1-3 parenchymal depth, <10 cm in length
III	Hematoma	Subcapsular, >50% surface area of ruptured subcapsular or parenchymal hematoma; intraparenchymal hematoma > 10 cm or expanding
	Laceration	>3 cm parenchymal depth
IV	Laceration	Parenchymal disruption involving 25% to 75% hepatic lobe or
		1-3 Couinaud’s segments
V	Laceration	Parenchymal disruption involving >75% of hepatic lobe or >3
		Couinaud’s segments within a single lobe
	Vascular	Juxtahepatic venous injuries; ie, retrohepatic vena
		cava/central major hepatic veins
VI	Vascular	Hepatic avulsion
*Advance one grade for multiple injuries up to grade III