The American Association for the Surgery of Trauma splenic injury grading scale has been applied to the increasingly non-operative management of splenic trauma. Grade I is subcapsular hematoma < 10% of the splenic surface and/or laceration < 1 cm deep. Grade II, as in this example is 10-50% surface hematoma or laceration 1-3 cm deep.
Grade III: > 50% hematoma or expanding; intraparenchymal hematoma > 5% or expanding. Failure rate of non-operative management for grade III injury except in children is 19%.
Grade IV (example shown): laceration involving segmental or hilar vessels with major devascularization. Grade V is a completely shattered spleen or devascularizing hilar injury.