Splenic injury

What it is

Splenic laceration is what the CT of the abdomen shows after blunt trauma to the abdomen, and its grade comes from the size of the laceration, the size of the subcapsular hematoma and the state of the hilum.

How it is diagnosed

FAST is done after resuscitation. CT follows once the patient is stable; if he did not respond to resuscitation he goes immediately to OT instead. CT tells you the exact source of bleeding, whether there is retroperitoneal bleeding, and whether there are multiple sources of bleeding. The grades run: Grade I, laceration under 1 cm with a subcapsular hematoma under 10% of surface area; Grade II, laceration of 1 to 3 cm with a subcapsular hematoma of 10 to 50% of surface area; Grade III, laceration over 3 cm, subcapsular hematoma over 50% of surface area, or a ruptured subcapsular or parenchymal hematoma; Grade IV, segmental or hilar vascular injury, or devascularization of more than 25% of the spleen; and Grade V, a shattered spleen or hilar injury.