What are the grades of splenic injury?

The grading is based on the CT scan, operative, or autopsy findings. There are five grades of splenic injury (Fig. 1; Table 1). Generally, grades I and II are considered as minor injuries, grade III as a moderate injury, and grades IV and V as severe injuries (Figs.

What is a grade 4 splenic injury?

Grade 4 is a laceration involving a hilar or segmental blood vessel if there is partial devascularization or if it is more than 25% of the spleen. Grade 5 is either a shattered spleen or complete devascularization of the entire spleen.

What is considered the gold standard for assessment of a splenic injury?

Although CT is considered the gold standard for detection and evaluation of blunt splenic injuries, ultrasound remains an essential tool for evaluation in both acute setting and follow-up.

Which grade of splenic injury is best managed with surgery?

The Eastern Association for the Surgery of Trauma (EAST) recommends NOM in blunt splenic trauma in all hemodynamically stable children irrespective of the AAST injury grade [140, 141].

What is a Grade 3 laceration?

A grade III laceration is characterized by a laceration that is > 3 cm of parenchymal depth, a subcapsular hematoma that is > 50% surface area of ruptured subcapsular or parenchymal hematoma, and an intraparenchymal hematoma that is > 10 cm or expanding. 13.

Why spleen is most commonly injured in blunt abdominal trauma?

Injuries to the spleen are one of the most common injuries in abdominal trauma. The spleen is the most vascular organ in the body. Since bleeding in splenic injuries is mainly arterial, significant haemoperitoneum can occur. Unrecognized injury can be a cause of preventable traumatic death.

How long after an injury can a spleen rupture?

A ruptured spleen is typically caused by a blow to the left upper abdomen or the left lower chest, such as might happen during sporting accidents, fistfights and car crashes. An injured spleen can rupture soon after the abdominal trauma or, in some cases, days or weeks after the injury.

How do you treat a splenic injury?

Some people require immediate surgery. Others heal with rest and time. Many small or moderate-sized injuries to the spleen can heal without surgery. You’re likely to stay in the hospital while doctors observe your condition and provide nonsurgical care, such as blood transfusions, if necessary.

How long does it take for a Grade 2 spleen laceration to heal?

A ruptured spleen can be life-threatening if not treated promptly. Treatment options vary depending on the severity of the condition and can include rest and observation, surgical repair, or splenectomy. Recovery from a ruptured spleen can take anywhere from 3 to 12 weeks.

What is a grade 4 liver laceration?

grade IV. laceration: parenchymal disruption involving 25-75% hepatic lobe or involves 1-3 Couinaud segments. vascular injury with active bleeding breaching the liver parenchyma into the peritoneum.

How long does it take for a Grade 2 spleen laceration to heal?

A ruptured spleen can be life-threatening if not treated promptly. Treatment options vary depending on the severity of the condition and can include rest and observation, surgical repair, or splenectomy. Recovery from a ruptured spleen can take anywhere from 3 to 12 weeks.

How long does it take a lacerated spleen to heal?

Savage et al indicated that splenic healing occurs within 2 to 2.5 months, regardless of the severity of initial injury, but they stressed the importance of clinical correlation. Within the pediatric surgical literature, multiple authors support 3 months for healing prior to return to activity.

What is splenic injury?

Splenic rupture occurs when the spleen is placed under intense pressure/duress, strong enough to tear or separate the outer lining of the organ. A ruptured spleen accounts for 10% of all abdominal injuries. When a blunt abdominal trauma is present, the spleen is the most frequently and often the only injured organ.

How long after an injury can a spleen rupture?

A ruptured spleen is typically caused by a blow to the left upper abdomen or the left lower chest, such as might happen during sporting accidents, fistfights and car crashes. An injured spleen can rupture soon after the abdominal trauma or, in some cases, days or weeks after the injury.

Can an injured spleen heal itself?

Many small or moderate-sized injuries to the spleen can heal without surgery. You’re likely to stay in the hospital while doctors observe your condition and provide nonsurgical care, such as blood transfusions, if necessary.