Table 0: of Grading System for Anatomic Severity of Disease in Emergency Local disease confined to the organ with minimal Local disease confined to the organ with severe Local extension
Table 1: Universal Grading System for Eight Emergent General Surgical Diseases AAST Disease Breast nfections Esophageal Preforation nfectious Colitis Pelvic nflammatory Disease to the organ Minimal to the organ Severe Cellulitis Mucosal tear Mucosal disease nflammation of the cervix Simple (without loculations, not involving the nipple/areolar complex) Full thickness tear with minimal inflammation Localized colon wall thickening or pseudomembranes or dilation Purulent cervical drainage Local extension beyond the organ Complex (i.e. loculations, involving nipple/areolar complex, axillary lymphadenopathy) Full thickness tear with localized Diffuse colon wall thickening or dilation, or coalescing pseudomembranes nflammation of the tubes, ovaries, and/or entire uterus beyond the organ Breast with suppurative ipsilateral lymphadenopathy, thrombophlebitis, lymphangitis Esophageal wall necrosis Localized colonic necrosis, with or without perforation Tubo-ovarian, pyometra Erosion into the chest wall or necrotizing fasciitis Empyema,, mediastinitis Diffuse transmural colonic necrosis, with or without perforation Generalized pelvic and peritoneal suppuration
Table 1: (Continued) AAST Disease Perirectal Abscess Pleural Space nfection Soft Tissue nfection Surgical Site nfection to the organ Minimal Perianal Localized, infected retained hemothorax or pleural effusion Cellulitis nfection involving skin only ntersphincteric or ischiorectal Generalized, infected retained hemothorax or pleural effusion Superficial necrosis OR liquefaction nfection involving subcutaneous tissue Locally extension Horseshoe or Multiple, loculated effusions extrasphincteric orhemothorax Subcutaneous nfection involving fascia or muscle layer Supralevator Organizing collection with restricted lung expansion Deep space nfection involving body cavity/deep space that was opened or manipulated during the surgery Necrotizing soft tissue infection of the perineum, buttocks (Fournier s gangrene) Mediastinal, diaphragm, or chest wall infection or necrosis Myonecrosis, fasciitis nvolvement of body cavity/deep space away from the site that was opened or manipulated during the surgery
Table 2: Grading for Eight Gastrointestinal Conditions Commonly Encountered in Emergency General Surgery AAST Disease Appendicitis Perforated Peptic Ulcer (Gastric or Duodenal) Acute Diverticulitis of Colon Acute Cholecystitis Local disease Confined to the organ Minimal Acutely inflamed appendix, intact Micro-perforation without Colonic inflammation Acute cholecystitis Gangrenous appendix, intact Contained perforation with localized Colon microperforation or pericolic phlegmon without Gall bladder empyema or gangrenous cholecystitis or emphysematous cholecystitis Local extension beyond with local the organ Perforation with localized and localized Localized pericolic fluid collection in lesser sac or right upper quadrant with local with periappendiceal phlegmon or Free perforation with Distant es with pericholecystic or gastrointestinal fistula with generalized Perforation with duodenal destruction ± penetration into adjacent organs and generalized Free colonic perforation with with generalized generalized
Table 2: (Continued) AAST Disease ntestinal Obstruction Small and Large Bowel Arterial schemic Bowel Hernias (nternal or Abdominal Wall) Acute Pancreatitis to the organ Minimal Partial obstruction schemia without tissue loss Reducible Acute edematous pancreatitis Complete obstruction, without bowel ischemia schemia with mucosal ulceration only, without transmural infarction ncarcerated without bowel ischemia Phlegmon OR peripancreatic fluid collection OR hemorrhage Locally extension Complete obstruction, bowel ischemic but viable ncarcerated with Segmental transmural bowel ischemic but infarction without preforation viable Sterile necrosis Complete obstruction with gangrenous bowel OR perforation with local spillage Segmental transmural infarction with perforation ncarcerated with gangrenous bowel OR perforation with local spillage nfected necrosis OR Perforation with diffuse peritoneal Pan-intestinal infarction ncarcerated with perforation and diffuse peritoneal Extra-pancreatic extension of necrosis involving adjacent organs, such as colonic necrosis