2020 Update for Blunt Colon Injury

Description

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

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