The American Association for the Surgery on Trauma (AAST) reported a severity grading system for emergency general surgery. This can be applied to acute appendicitis.
Operative
Inflammation
Perforation
Grade
none (normal)
none
0
acute inflammation
none
I
gangrenous inflammation
none
II
NA
with local contamination
III
NA
with periappendiceal phlegmon or abscess
IV
NA
with generalized peritonitis
V
Imaging
Thickening of Wall
Other Finding
Grade
none (normal) or not visualized
none
0
> 6 mm
mild periappendiceal edema
I
> 6 mm
severe periappendiceal edema
II
> 6 mm
severe periappendiceal thickening and free intra-peritoneal fluid in RLQ
III
> 6 mm
with abscess or phlegmon
IV
> 6 mm
with free intra-peritoneal fluid beyond RLQ
V
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