AASTPancreatic Injury ScalePatient Education GuideHighest Finding (Imaging/ERCP/OR)IContusion or minor laceration WITHOUT duct injuryIIMajor laceration WITHOUT duct injury or tissue lossIIIDistal transection or parenchymal injury WITH duct injuryIVProximal transection or parenchymal injury involving the ampullaVMassive disruption of the pancreatic headDetermine GradePancreas Injury GradingSelect the highest finding from imaging or operative exploration.Guidelines & EvidenceWhen to UseHow it WorksClinical PearlsNext StepsThe EvidenceOrigins & HistorySection 1When to UseSection 2How it WorksSection 3Clinical PearlsSection 4Next StepsSection 5The EvidenceSection 6Origins & HistoryVerifiedLast Review: 2026When to UseWhen to UseBlunt abdominal trauma (especially epigastric impact, handlebar injuries)Penetrating trauma involving upper abdomen or retroperitoneumUnexplained epigastric pain following traumaElevated serum amylase/lipase in trauma context (supportive, not diagnostic)CT findings suggestive of pancreatic injury (peripancreatic fluid, gland disruption)Intraoperative identification of pancreatic injuryClinical UtilityDetermines operative vs non-operative managementIdentifies need for distal pancreatectomy vs drainagePredicts complications such as fistula, abscess, and pancreatitisStandardizes reporting in trauma registriesGuides need for ERCP or MRCP in suspected ductal injuryKey LimitationThe most critical determinant—main pancreatic duct injury—is often missed on initial CT imaging, leading to delayed diagnosis and increased morbidity.LimitationsCT sensitivity for ductal injury is limited, especially early after traumaDoes not incorporate physiologic status or associated injuriesRetroperitoneal location delays clinical presentationInter-observer variability in imaging interpretationLast Comprehensive Review: 2026