What is a Level 4 laceration?

Grade 4: Laceration involving the collecting system with urinary extravasation; any segmental renal vascular injury; renal infarction; renal pelvis laceration and/or ureteropelvic disruption. Grade 5: Shattered or devascularized kidney with active bleeding; main renal vascular laceration or avulsion.

What is organ injury scale?

Conceptually, the OIS is a classification scheme based on the anatomic disruption of an individual organ scaled 1 to 6, representing the least to most severe injury.

Is a Grade 4 liver laceration major?

The WSES position paper suggested dividing hepatic traumatic lesions into minor (grade I, II), moderate (grade III) and major/severe (grade IV, V, VI) [6]. This classification has not previously been clearly defined by the literature.

What is a Grade 5 liver laceration?

Grade V: laceration: parenchymal disruption involving >75% of hepatic lobe or >3 Couinaud segments within a single lobe; vascular: juxtahepatic venous injuries (ie, retrohepatic vena cava/central major hepatic veins).

What is a Grade 5 splenic laceration?

Grade 5 is either a shattered spleen or complete devascularization of the entire spleen. These grades often guide treatment decisions, such as if observational or operative management is chosen for the spleen injury by the treating surgeon.

What type of injury classification is injury of the fascia?

The term ‘soft tissue injury’ is often used to describe injuries mainly to ligaments, tendons and muscles or to the ‘fascia’, the connective tissue that binds the body. Injuries to these structures may be haematoma formations (bleeding in or around the structure) or may be actual tears.

What is a grade 3 splenic laceration?

Grade 3: This mid-stage rupture is a tear more than 3 cm deep. It can also involve the splenic artery or a hematoma that covers over half of the surface area. A grade 3 rupture can also mean that a hematoma is present in the organ tissue that is greater than 5 cm or expanding.

What is a Grade 3 liver laceration?

A grade III laceration is characterized by a laceration that is > 3 cm of parenchymal depth, a subcapsular hematoma that is > 50% surface area of ruptured subcapsular or parenchymal hematoma, and an intraparenchymal hematoma that is > 10 cm or expanding.

How bad is a Grade 4 liver laceration?

AAST liver injury classifications Grade IV and greater require surgical intervention to stop the bleeding. A liver laceration can be life threatening and can result in death.

What is a grade 4 splenic injury?

Grade 4 is a laceration involving a hilar or segmental blood vessel if there is partial devascularization or if it is more than 25% of the spleen. Grade 5 is either a shattered spleen or complete devascularization of the entire spleen.

What is a Grade 3 spleen injury?

Grade 3 is hematoma of more than 50% of the subcapsular surface area or if the hematoma is known to be expanding over time, if the hematoma has ruptured, intraparenchymal hematoma either more than 5 cm or known to be expanding, or capsule laceration more than 3 cm in depth and/or involving a trabecular blood vessel.

How do you grade multiple injuries on the organ injury scale?

*Advance one grade for multiple injuries up to grade III. *This classification system is applicable to extraparenchymal vascular injuries. If the vessel injury is within 2 cm of the organ parenchyma, refer to specific organ injury scale. Increase one grade for multiple grade III or IV injuries involving > 50% vessel circumference.

What is the rate of incidence of duodenal injuries?

Duodenal injuries are uncommon Incidence of blunt duodenal injury;0.2% Penetrating(78%) wounds are more common than blunt(22%) Duodenal injuries are both difficult to diagnose and repair due to its retroperitoneal location Duodenal Anatomy First portion of the small intestine From the plyoric ring to the Treitz ligament

How reliable is multidetector CT in the evaluation of duodenal injuries?

In addition, multidetector CT reliably demonstrates potential complications of duodenal and pancreatic injuries, such as posttraumatic pancreatitis, pseudocysts, fistulas, exudates, and abscesses. Blunt pancreatic and duodenal trauma is uncommon, amounting to less than 2% of all abdominal injuries.

What are the mortality rates for duodenal and Pancreatic injuries?

Mortality for pancreatic injuries ranges from 9% to 34%; for duodenal injuries it ranges from 6% to 29%. However, only 5% of the pancreatic injuries and 30% of the duodenal injuries are directly related to the fatal outcome.