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


Completely shattered spleen

Hilar Injury which devascularizes spleen

7 weeks