Tominaga et al reported an updated injury scale for blunt large bowel trauma.The authors are from multiple institutions in the United States and the AAST Patient Assessment Committee.
Detection may be based on CT, operative or pathologic findings
Parameters:
(1) large bowel wall thickening
(2) large bowel wall hematoma
(4) free air
(5) extraluminal oral contrast or intestinal material
(6) wall laceration
(7) contrast enhancement of large bowel wall on CT
Parameter |
Finding |
AAST Grade |
large bowel wall thickening |
none |
0 |
|
focal without free fluid or devascularization |
I |
|
focal with small volume free fluid |
II |
|
focal with moderate to large volume of free fluid |
III |
|
focal with adjacent interloop free fluid |
III |
large bowel wall hematoma |
none |
0 |
|
without free fluid or devascularization |
I |
|
with small volume free fluid |
II |
|
with moderate to large volume of free fluid |
III |
|
with adjacent interloop free fluid |
III |
free air |
none |
0 |
|
pneumoperitoneum or pneumo-retroperitoneum |
IV |
extraluminal oral contrast or intestinal material |
none |
0 |
|
present |
IV |
wall laceration |
none |
0 |
|
serosal tear |
I |
|
full thickness injury without contamination |
II |
|
full thickness injury with minimal contamination |
III |
|
wall defect or bowel transection |
IV |
|
transection with destructive bowel injury including devasculariation |
V |
|
transection with segmental tissue loss and peritonitis |
V |
enhancement bowel wall |
yes |
0 |
|
no |
V |
For adult with Grade II or IV injury: upgrade 1 grade for >= 8 hour delay in diagnosis from time of injury
AAST Grade |
AIS Severity |
I |
2 |
II |
3 |
III |
3 |
IV |
4 |
V |
5 |
Specialty: Surgery, orthopedic, Emergency Medicine