Duodenum injury-trauma grading

Duodenal injuries are graded I-V with increasing severity having higher grading.

Grade I

• Duodenal hematoma involving a single portion
• Duodenal laceration that is partial thickness without perforation

Grade II

• Duodenal hematoma involving more than one portion
• Duodenal laceration with disruption of <50% of circumference

Grade III

• Duodenal laceration with disruption of 50-75% of circumference in D2 portion
• Duodenal laceration with disruption of 50-100 of circumference in D1, D3, D4 portions

Grade IV

• Duodenal laceration with disruption of >75% of circumference in D2 portion
• Duodenal laceration involving the ampulla or distal common bile duct

Grade V

• Duodenal laceration involving massive disruption of the duodenopancreatic complex
• Duodenal vascular injury involving devascularization of the duodenum

Note to advance one grade for multiple injuries up to grade III.

• D1 = First portion of Duodenum
• D2 = Second portion of Duodenum
• D3 = Third portion of Duodenum
• D4 = Fourth portion of Duodenum

References

Moore EE, et al. Organ injury scaling: pancreas, duodenum, small bowel, colon and rectum. J trauma. 1990;30(11):1427-9.

[Outline]

• Information
• Grade I
• Grade II
• Grade III
• Grade IV
• Grade V
• References