Grade II spleen injury

Case contribution: Dr Radhiana Hassan


  • A 13 years old male
  • Fall from motorbike
  • No loss of consciousness
  • Complaint of abdominal pain
CT scan abdomen in axial plane soft tissue window post contrast

CT scan findings:

  • There areĀ  multiple small intraparenchymal hematoma seen (red arrows)
  • A laceration is also seen at lower pole about 2 cm (yellow arrow)
  • There is associated perisplenic blood collection (white arrow)
  • Other organs are normal.

Diagnosis: Grade II spleen injury


  • Grade II spleen injury is defined as subcapsular hematoma is 10-50% of surface area
  • or with intraparenchymal hematoma of less than 5 cm in diameter
  • or intraparenchymal laceration 1-3 cm depth that does not involve trabecular vessel

Progress of patient:

  • Initially treated conservatively
  • In ward Hb drop from 12 to 8.6
  • Had blood transfusion with one DIVC regime
  • Subsequently operation done due to failed conservative management
  • Intraoperative findings: Laceration at tip of spleen about 4 cm. Hilum intact. Contusion at pancreatic tail. Hemoperitoneum about 1100 cc.
  • Splenectomy done
  • He was discharged 4 days after the operation (Day 6 of admission)
  • Subsequent follow up: patient was well
Author: radhianahassan