AAST stomach, duodenum, small intestine, and colon injury scales

Injured structure	AAST grade*	Description of injury
Stomach	I	Contusion/hematoma; partial-thickness laceration
	II	Laceration <2 cm in GE junction or pylorus; <5 cm in proximal 1/3 stomach; <10 cm in distal 2/3 stomach
	III	Laceration >2 cm in GE junction or pylorus; >5 cm in proximal 1/3 stomach; >10 cm in distal 2/3 stomach
	IV	Tissue loss or devascularization <2/3 stomach
	V	Tissue loss or devascularization >2/3 stomach
Duodenum	I	Hematoma involving single portion of duodenum; partial-thickness laceration, no perforation
	II	Hematoma involving more than one portion of duodenum; laceration causing disruption <50% of circumference
	III	Laceration causing disruption 50 to 75% of circumference of D2; disruption 50 to 100% of D1, D3, D4
	IV	Laceration causing disruption >75% of circumference of D2; laceration involving ampulla or distal common bile duct
	V	Massive disruption of duodenopancreatic complex; devascularization of duodenum
Small bowel	I	Contusion or hematoma without devascularization; partial-thickness laceration, no perforation
	II	Laceration involving <50% of circumference
	III	Laceration involving ≥50% of circumference without transection
	IV	Transection of the small bowel
	V	Transection of the small bowel with segmental tissue loss; devascularized segment
Colon	I	Contusion or hematoma without devascularization; partial-thickness laceration; no perforation
	II	Laceration involving <50% of circumference
	III	Laceration involving ≥50% of circumference without transection
	IV	Transection of the colon
	V	Transection of the colon with segmental tissue loss; devascularized segment
Rectosigmoid and rectum	I	Contusion or hematoma without devascularization; partial-thickness laceration
	II	Laceration involving <50% of circumference
	III	Laceration involving ≥50% of circumference
	IV	Full-thickness laceration with extension into the perineum
	V	Devascularized segment

AAST: American Association for the Surgery of Trauma; GE: gastroesophageal; D1: first portion of the duodenum; D2: second portion of the duodenum; D3: third portion of the duodenum; D4: fourth portion of the 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 scaling, 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 (Accessed on December 10, 2019).

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AAST stomach, duodenum, small intestine, and colon injury scales