The AAST organ injury scale (OIS) for splenic injury classifies a Grade IV injury as:
- A Laceration involving segmental or hilar vessels producing >25% devascularisation ✓
- B Laceration of splenic capsule <1 cm parenchymal depth
- C Laceration 1–3 cm parenchymal depth not involving a trabecular vessel
- D Completely shattered spleen or hilar avulsion devascularising the entire spleen
Correct answer: A. Laceration involving segmental or hilar vessels producing >25% devascularisation
Explanation
AAST splenic OIS: Grade I — subcapsular haematoma <10% surface area or capsular laceration <1 cm depth; Grade II — subcapsular haematoma 10–50% or laceration 1–3 cm not involving trabecular vessel; Grade III — subcapsular haematoma >50% or expanding, laceration >3 cm or involving trabecular vessel; Grade IV — laceration involving segmental/hilar vessels with >25% devascularisation; Grade V — completely shattered or hilar avulsion. Non-operative management (NOM) success rates decrease progressively with grade.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.