2020 Update for Penetrating Colon Organ Injury

Description

Tominaga et al reported an updated injury scale for penetratinglarge 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 contusion or hematoma

(2) wound track

(3) large bowel wall injury

(4) extraluminal oral contrast or intestinal material

(5) mesenteric findings

(6) enhancement of large bowel wall

(7) bleeding within large bowel lumen

Parameter	Finding	AAST Grade
contusion or hematoma	absesnt	0
	present without devascularization	I
wound track	none	0
	into peritoneum or retro-peritoneum with small amount nonphysiologic volume fluid	I
	into peritoneum or retroperitoneum with small volume free fluid	II
	into peritoneum or retroperitoneum with moderate or large volume free fluid	III
	into peritoneum or retroperitoneum with moderate hemoperitoneum	IV
	wound track leading to or abutting large bowel wall	IV
large bowel wall injury	none	0
	serosal tear	I
	full thickness injury without transection, contamination or peritonitis	II
	full thickness injury without transection but with minimal contamination or peritonitis	III
	transection with minimal contamination or peritonitis	IV
	transection with destructive injury	V
	transection with segmental tissue loss and significant peritonitis	V
extraluminal oral contrast or intestinal material	absent	0
	present	V
mesenteric findings	none	0
	isolated mesenteric fat streaking on imaging studies	II
	hematoma adjacent to but not abutting bowel wall	III
enhancement of wall	present	0
	absent	V
bleeding within large bowel lumen	absent	0
	present	IV

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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2020 Update for Penetrating Colon Organ Injury

Description

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