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Guidelines for Pediatric Spleen Injury

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ATOMAC Guidelines

 

Spleen Injury

See ATOMAC Guideline

Grade Injury Type Description of Injury       Activity Restriction

 

 

I

Hematoma

Subcapsular, < 10% surface area

 

 

 

3 weeks

 

 

Laceration

Capsular tear, < 1cm parenchymal depth

II

Hematoma

Subcapsular, 10-50% surface area intraparenchymal, < 5cm in diameter

 

 

 

4 weeks

 

 

Laceration

Capsular tear, 1-3 cm parnchymal depth that does not involve a trabecular vessel

III

Hematoma

Subcapsular, >50% surface area or expanding; ruptured subcapsular or parnchymal hematoma; intraparenchmal hematoma > or = 5cm or expanding

 

 

 

5 weeks

 

 

Laceration

>3 cm parenchymal depth or involving trabecular vessels

IV

Laceration

Laceration involving segmental or hilar vessels producing major devascularization (>25% of spleen)

 

 

 

6 weeks

 

 

V

Shattered

Vascular

Completely shattered spleen

Hilar Injury which devascularizes spleen

      7 weeks    

 

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