The American Association for the Surgery of Trauma (AAST) injury scoring scales are the most widely accepted and used system of classifying and categorising traumatic injuries. Injury grade reflects severity, guides management, and aids in prognosis. At the time of writing (mid 2016), 32 differe...
The 1994 revision of the American Association for the Surgery of Trauma (AAST) splenic injury scale is the most widely used grading system for splenic trauma at the time of writing (late 2016).
subcapsular haematoma <10% of surface area
capsular laceration <1 cm depth...
Abdominal hernias (herniae also used) may be congenital or acquired and come with varying eponyms. They are distinguished primarily based on location and content. 75-80% of all hernias are inguinal.
Content of the hernia is variable, and may include:
small bowel loops
mobile colon segments (s...
The Amsterdam criteria are used in the diagnosis hereditary non polyposis colorectal cancer (HNPCC).
Amsterdam Criteria I
Initial description in 1991:
> or equal to 3 relatives with colorectal cancer (CRC)
> or equal to 1 case in a first degree relative
> or equal to 2 successive generation...
The Balthazar score is a subscore within the CT severity index (CTSI) for grading of acute pancreatitis.
The CTSI sums two scores:
Balthazar score: grading of pancreatitis (A-E)
grading the extent of pancreatic necrosis
The Balthazar score was originally used alone, but the addition of a sc...
The Bethesda criteria are an alternative to the Amsterdam criteria for the clinical diagnosis of hereditary non-polyposis colorectal cancer (HNPCC).
Diagnosis of HNPCC is made if any of the following criteria are fulfilled:
Amsterdam criteria are met
2 or more HNPCC related malignancies
Use only the size of the tumor during evaluation of response to chemotherapy has some pitfalls and limitations, especially when the estimated response for specific tumors such as gastrointestinal stromal tumour (GIST).
The Choi response criteria for GIST proposed that tumour attenuation could p...
This congenital extrahepatic portosystemic shunt classification was proposed by Morgan and Superina in 1994 1:
type 1: complete diversion of portal blood into the Inferior vena cava with congenital absence of the portal vein
1a: superior mesenteric vein and splenic vein do not join to form a c...
This congenital intrahepatic portosystemic shunt classification was proposed by Park et al. in 1990 1:
type 1: single large vessel of constant diameter connecting the right portal vein to the Inferior vena cava
type 2: localised, peripheral shunt with one or more communications in a single hep...
CT colonography reporting and data system is a method devised to standardise CT colonography reporting.
It primarily classifies abnormalities into colonic (C) and extra-colonic (E).
C0: inadequate study
C1: normal colon/benign lesion: routine screening ...
The CT severity index (CTSI) is based on findings from a CT scan with intravenous contrast to assess the severity of acute pancreatitis. The severity of computed tomography findings have been found to correlate well with clinical indices of severity.
The CTSI sums two scores:
Degloving injuries can refer to a number of conditions:
degloving soft tissue injury
Morel-Lavallee lesion (closed degloving soft tissue injury)
intramuscular degloving injury
degloving bowel injury
Duplex appendix is a rare anomaly of the appendix and is usually discovered incidentally during surgery for appendicitis.
Duplication of the vermiform appendix is extremely rare. It is found in only 1 in 25,000 patients (incidence ~0.004%) operated on for acute appendicitis. Altho...
Gastric cancer staging is routinely performed using the TNM staging system. This article is based on the 7th edition of the TNM classification of malignant tumours.
TNM staging (7th edition)
T1a: tumour invades the lamina propria and or muscularis mucosae
T1b: tumour invades submucosa...
Gastric lymph node stations were originally divided into 16 groups proposed by the Japanese Research Society for Gastric Cancer in 1963.
The areas of stomach which drain into regional lymph nodes:
cardia and proximal lesser curvature drain into left gastric lymph nodes, then int...
E J Hinchey et al. 3 proposed a classification for acute diverticulitis, that has been variously adapted, and is useful not only in academia but also in outlining successive stages of severity.
stage 1a: phlegmon
stage 1b: diverticulitis with pericolic or mesenteric abscess
Ishikawa classification system describes the degree of involvement of adjacent portal vein and SMV by pancreatic ductal adenocarcinoma based on calibre of the vein:
type I: normal
type II: smooth shift/displacement with normal calibre
type III: unilateral narrowing
type IV: bilateral nar...
The Krenning score is a proposed semi-quantitative method of assessing the degree of tracer uptake on octreotide scintigraphy.
Initially designed for assessment of 111In-DTPA on planar imaging, the Krenning score is applicable to SPECT or SPECT/CT using various radiopharmaceuticals....
Meandering main pancreatic duct (MMPD) comprises of a reverse Z-type and loop-type of pancreatic ducts.
These ductal variants are found in ERCP and MRCP studies. The exact incidence is not known.
Increased incidence of meandering pancreatic duct has been reported in patients with idiopathic re...
The modified CT severity index is an extension of the original CT severity index (CTSI) was developed by Balthazar and colleagues in 1994 for distinguishing mild, moderate and severe forms of acute pancreatitis.
The original CT severity index has been followed internationally and has been very ...
Mucinous neoplasms of the appendix are epithelial tumours of the appendix that produce mucin. According to a panel of specialists consensus published in 2016, a new nomenclature and classification for the appendiceal mucinous neoplasms based on their histologic type and biologic behaviour has be...
Necrotising enterocolitis (NEC) can be staged into three groups, helping to guide appropriate treatment. In general, stage I and II are managed medically whereas stage III is managed surgically.
lethargy, temperature instability, apnoea, bradycardia
emesis, abdominal d...
Oesophageal atresia is closely related to tracheo-oesophageal fistula and can be divided into1:
type A: isolated oesophageal atresia (8%)
type B: proximal fistula with distal atresia (1%)
type C: proximal atresia with distal fistula (85%)
type D: double fistula with intervening atresia (1%)
A number of pancreatic injury grading systems have been proposed.
American Association for the Surgery of Trauma (AAST)
grade 1: haematoma with minor contusion/laceration but without duct injury
grade 2: major contusion/laceration but without duct injury
grade 3: distal lace...
Ranson's criteria are useful in assessing prognosis in early acute pancreatitis. The more of the criteria are met the higher the mortality. Ranson's criteria are assessed both at admission and at 48 hours.
age: >55 years
white blood count: >16 000/mm
blood glucose leve...
RASopathies are a class of developmental disorders caused by germline mutations in genes that encode for components or regulators of the Ras/mitogen activated protein kinase (MAPK) pathway.
As a group, RASopathies represent one of the most common malformation syndromes, with an in...
The Revised Atlanta classification of acute pancreatitis (2012) is an international multidisciplinary classification of the severity of acute pancreatitis, updating the 1991 Atlanta classification. This has been further revised in 2016 6.
The worldwide consensus aims for an internationally agre...
The Tanaka criteria, also referred as Fukuoka consensus guidelines, is a classification system for intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs).
The prior international consensus guidelines (2006) were referred to as the Sendai criteria, which later evo...
The World Health Organisation classifies anal canal neoplasms into intraepithelial neoplasms and invasive neoplasms which are further divided to epithelial and non-epithelial tumours and secondary lesions:
squamous cell carcinoma of anal canal
adenocarcinoma of anal canal
The WHO classification of anal margin tumours or perianal skin tumours is:
Bowen disease (precursor of squamous cell carcinoma)
Paget's disease (precursor of adenocarcinoma)
squamous cell carcinoma
basal cell carcinoma