Abdominal vascular injury-trauma grading

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

Grade I

• Gonadal artery/vein
• Lumbar artery/vein
• Ovarian artery/vein
• Phrenic artery/vein
• Non-named superior or inferior mesenteric artery or vein branches
• Other non-named arterial or venous structure requiring ligation

Grade II

• Gastric arteries (Right or Left)
• Gastroduodenal artery
• Hepatic arteries (Right, Left or common)
• Inferior mesenteric artery or vein
• Splenic artery/vein
• Primary named branches of mesenteric artery or vein
• Other named abdominal vessels requiring ligation

Grade III

• Hypogastric artery/vein
• Iliac artery/vein
• Renal artery/vein
• Superior mesenteric vein
• Vena cava (Infrarenal)

Grade IV

• Aorta (Infrarenal)
• Celiac axis
• Superior mesenteric artery
• Suprarenal, infrahepatic vena cava

Grade V

• Aorta (Suprarenal, subdiaphragmatic)
• Hepatic vein (extra-parenchymal)
• Portal vein
• Vena cava (retro or suprahepatic)

Notes

1. This system is applicable to extraparenchymal vascular injuries
2. If the vessel injury is within 2 cm of the organ parenchyma, then the specific organ injury scale (not this scale) should be applied
3. Increased by 1 grade for multiple grade III or IV injuries involving >50% vessel circumference
4. Downgrade one grade if <25% vessel circumference lacerated for grades IV or V.

References

Moore EE, et al. Organ injury scaling III: chest wall, abdominal vascular, ureter, bladder and urethra. J trauma. 1992;33:337-8. Trauma scoring. Trauma.org. Available at http://www.trauma.org/archive/scores/ois-abdovasc.html (Accessed 23 April 2008)

[Outline]

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