Gastric blunt traumatic injuries: A computed tomography grading classification

Table 1 Computed tomography signs of gastric blunt traumatic injuries

CT signs of gastric blunt traumatic injuries (n. 57 in 32)
Gastric wall discontinuity	1
Extraluminal air	10
Peritoneal fluid	28
Hematoma	11
Contrast material	3
Luminal content extravasation	1
Gastric wall thickening	15
Pneumatosis of gastric wall	3

CT: Computed tomography.

Table 2 Abdominal associated lesions

Abdominal associated lesions (n. 33 in 27 patients)
Large bowel	2
Spleen	14
Liver	9
Left kidney	3
Right kidney	1
Pancreas	1
Mesentery	3

Table 3 Location of gastric lesions

Location of gastric lesions
Fundus	17
Body	15
Anterior wall	7
Greater curvature	2
Small curvature	1
Posterior surface	3
Antrum	3
Not detectable	1

Table 4 Grading computed tomography of gastric blunt traumatic injuries

	Pathology	CT signs	Treatment
Grade 1	Gastric contusion	Gastric wall thickening No peritoneal fluid Perigastric pneumatosis	No surgery
Grade 2	Minor lacerations involving the mucosal side	High-attenuation hematoma confined to the inner side, blood in the gastric lumen Small amount of non-bloody peritoneal fluid	Follow-up
Grade 3	Partial laceration with parietal hematoma and/or stretching of the external layer	Peritoneal hematoma collection, gastric wall thickening with high-attenuation of the external side	Close follow-up/ surgery
Grade 4	Full thickness rupture Vascular involvement (necrosis or active bleeding)	Extraluminal air Luminal content extravasation Contrast material extravasation	Emergency surgery

CT: Computed tomography.