According to the American Association for the Surgery of Trauma (AAST) colon injury grading scale, how is a colonic laceration involving more than 50% of the bowel wall circumference without complete transection classified?

1. A

   A. Grade II

2. B

   B. Grade III

3. C

   C. Grade IV

4. D

   D. Grade V

Appeared in: INI-CET EXAM -2026

Explanation

• The AAST colon injury scale is a standardized system used to classify the severity of traumatic injuries to the colon.
• A Grade III injury is specifically defined as a laceration that extends through more than 50% of the colonic wall's circumference but does not completely sever the bowel.
• The question describes an injury that perfectly matches the criteria for a Grade III classification: a large laceration (>50%) without a full transection.

Why Other Options Were Wrong

• Option A: Grade II injuries are less severe, involving a laceration that covers less than 50% of the bowel's circumference.
• Option C: Grade IV represents a more severe injury where the colon is completely transected (cut into two separate pieces).
• Option D: Grade V is the most severe classification. It involves not only a complete transection but also the loss of a segment of the colon or a loss of its blood supply (devascularization).

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Clinical Relevance

• Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing AAST Colon Injury Grading Scale in acute care settings.
• The AAST grading is critical for surgical decision-making. A Grade III injury might be managed with primary repair, whereas higher-grade injuries (IV and V) often require resection of the damaged segment, potentially with a temporary colostomy.
• Nurses caring for patients with colon injuries must monitor for signs of complications like peritonitis, sepsis, and anastomotic leak, the risk of which increases with higher injury grades.
• Understanding this scale helps the entire trauma team communicate effectively about the patient's condition and prognosis.

How to Approach the Question

• First, identify the key components of the injury described in the question: the organ (colon), the type of injury (laceration), and the extent of the injury (>50% circumference, without complete transection).
• This is a factual recall question that requires knowledge of a specific classification system, the AAST colon injury scale.
• Systematically go through the grades of the AAST scale in your mind or as recalled from study materials.
• Match the description in the question to the correct grade definition.
• Grade I is a bruise or partial tear. Grade II is a tear <50%. Grade III is a tear >50% without transection. Grade IV is a complete transection. Grade V is transection with tissue loss.
• The description directly corresponds to the definition of a Grade III injury.

Concept Tested & Keywords

• Concept Tested: AAST Colon Injury Grading Scale
• Stem keywords: AAST, American Association for the Surgery of Trauma, colon injury, grading scale, laceration, more than 50%, without complete transection
• Lead-in keywords: how is... classified

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