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 Couinaudís segments

V

Laceration

Parenchymal disruption involving >75% of hepatic lobe or >3

 

 

Couinaudís 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