Tominaga et al reported an updated injury scale for mesenteric 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) mesenteric contusion (haziness or opacity within the mesentery; inhomogeneous fluid density within the mesenteric fat)
(2) mesenteric hematoma (discrete soft tissue density within bowel mesentery)
(3) mesenteric vessel
(4) enhancement of associated bowel wall on CT imaging
(5) full thickness mesenteric injury
Parameter
Finding
AAST Grade
mesenteric contusion
no
0
isolated without additional free fluid or bowel wall thickening
I
with associated bowel wall thickening
IV
mesenteric hematoma
none
0
less than 5 cm without associated bowel wall thickening or adjacent interloop fluid collection
II
GTE 5 cm without associated bowel wall thickening or adjacent interloop fluid collection
III
with associated bowel wall thickening
IV
mesenteric vessel
normal
0
abrupt termination
IV
active bleeding or IV contrast extravasation
V
bowel wall
enhancement
0
nonenhancement
V
full thickness injury
none
0
with associated viable bowel
IV
with associated devascularized nonviable bowel
V
where:
• Interloop fluid collection is fluid within the mesentery and/or between loops of bowel, frequently triangular in shape.
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