The American Association for the Surgery of Trauma (AAST) has reported criteria for grading esophageal lesions ranging from mucosal tears to perforations.
Patient selection: defect in esophageal wall
Parameters:
(1) location and extent
(2) additional findings
Location and Extent
Additional Findings
Grade
mucosal tear
limited findings, possible intramucosal air
I
full thickness tear with minimal inflammation
esophageal thickening, possible subcutaneous emphysema
II
full thickness tear with localized abscess
air/gas in prevertebral planes; mediastinal emphysema or abscess
III
necrosis of the esophageal wall
mediastinal widening
IV
perforation with disseminated inflammation (empyema, mediastinitis and/or peritonitis)
V
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