Table 4 Pancreaticoduodenal injury scale by the American Association for the Surgery of Trauma (AAST)
Grade | Organ | Injury description | Number(%) |
|---|---|---|---|
I (Hematoma /Laceration) | Pancreas | a. Minor contusion without ductal injury | 0 |
b. Superficial laceration without ductal injury | |||
Duodenum | a. Hematoma: involving a single portion of duodenum | 0 | |
b. Laceration: partial thickness, no perforation | |||
II (Hematoma /Laceration) | Pancreas | a. Major contusion without ductal injury or tissue loss | 0 |
b. Major laceration without ductal injury or tissue loss | |||
Duodenum | a. Hematoma: involving more than one portion | 0 | |
b. Laceration: with disruption of less than 50% of circumference | |||
III (Laceration) | Pancreas | Distal transection or parenchymal injury with ductal injury | 0 |
Duodenum | a. Disruption 50–75% of circumference of D2 | 1 (8.3%) | |
b. Disruption 50–100% of circumference of D1, D3, and D4 | |||
IV (Laceration) | Pancreas | Proximal transection or parenchymal injury involving the ampulla | 5 (41.7%) |
Duodenum | Disruption > 75% of circumference of D2 involving ampulla or distal common bile duct | 0 | |
V (Laceration) | Pancreas | Massive disruption of the pancreatic head | 7 (58.3%) |
Duodenum | a. Laceration: massive disruption of duodeno-pancreatic complex | 8 (66.7%) | |
b. Vascular: devascularization of duodenum |