AAST duodenum injury scale

Grade*	Type of injury	Description of injury
I	Hematoma	Involving single portion of duodenum
I	Laceration	Partial thickness, no perforation
II	Hematoma	Involving more than one portion
II	Laceration	Disruption <50% of circumference
III	Laceration	Disruption 50 to 75% of circumference of D2
III	Laceration	Disruption 50 to 100% of circumference of D1, D3, D4
IV	Laceration	Disruption >75% of circumference of D2
IV	Laceration	Involving ampulla or distal common bile duct
V	Laceration	Massive disruption of duodenopancreatic complex
V	Vascular	Devascularization of duodenum

AAST: American Association for the Surgery of Trauma; D1: first position of duodenum; D2: second portion of duodenum; D3: third portion of duodenum; D4: fourth portion of duodenum.
* Advance one grade for multiple injuries up to grade III.

Reproduced with permission from: Moore EE, Cogbill TH, Malangoni MA, et al. Organ injury scalin, II: Pancreas, duodenum, small bowel, colon, and rectum. J Trauma 1990; 30:1427. Copyright © 1990 Lippincott Williams & Wilkins. Available at: https://www.aast.org/resources-detail/injury-scoring-scale#duodenum (Accessed on December 10, 2019).

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AAST duodenum injury scale