| Classification | Description | Notes |
| Grade 1 | – Subcapsular hematoma <10% surface area
– Parenchymal laceration <1 cm depth – Capsular tear |
|
| Grade 2 | – Subcapsular hematoma 10–50% surface area;
— Intraparenchymal hematoma <5 cm – Parenchymal laceration 1–3 cm |
|
| Grade 3 | – Subcapsular hematoma >50% surface area;
Ruptured subcapsular or intraparenchymal hematoma ≥5 cm – Parenchymal laceration >3 cm depth |
|
| Grade 4 | – 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 |
|
| Grade 5 | – Any injury in the presence of splenic vascular
injury with active bleeding extending beyond the spleen into the peritoneum – Shattered spleen |
Note: Advance one grade for multiple splenic injuries up to grade 3.
Reference:
Kozar RA et al. (2018). Organ injury scaling 2018 update: Spleen, liver, and kidney. J Trauma Acute Care Surg; 85(6):1119- 1122