We think this might be relevant to the clinical guidance for American Association for the Surgery of Trauma (AAST) Diaphragm Injury Scale.
AAST Diaphragm Injury Scale
AASTDiaphragm Injury Scale
Highest Finding (Imaging/OR)
Diaphragm Injury Grading
Select the highest radiologic or operative finding to determine the AAST severity grade.
Guidelines & Evidence
Verified
Last Review: 2026
When to Use
The AAST Diaphragm Injury Scale is indicated in patients with suspected traumatic diaphragmatic injury (TDI), particularly following penetrating thoracoabdominal trauma (e.g., stab or gunshot wounds between nipples and costal margin) or high-energy blunt trauma with pelvic or thoracoabdominal involvement. It is most useful in hemodynamically stable patients undergoing diagnostic laparoscopy, CT imaging, or during exploratory laparotomy/thoracotomy. The scale stratifies injury severity to inform repair strategy and helps predict risk of herniation or missed injury complications.
The scale has limited sensitivity on CT for small lacerations (miss rate historically 10-30% for penetrating injuries). It does NOT predict physiologic instability or replace clinical judgment in hypotensive patients where immediate operative exploration takes precedence.
