We think this might be relevant to the clinical guidance for American Association for the Surgery of Trauma (AAST) Rectal Injury Scale.
AAST Rectal Injury Scale
AASTRectal Injury Scale
Highest Finding (CT/OR)
Rectum Injury Grading
Select the highest finding from CT or operative exploration.
Guidelines & Evidence
Verified
Last Review: 2026
When to Use
The AAST Rectal Injury Scale is indicated in patients with suspected rectal trauma, most commonly from penetrating mechanisms such as transpelvic gunshot wounds, impalement, or iatrogenic injury. It is also used in blunt pelvic trauma with associated pelvic fractures and in any patient undergoing proctoscopy, sigmoidoscopy, or exploratory laparotomy with pelvic hematoma. The scale guides the critical decision between primary repair and fecal diversion.
Rectal injuries carry high risk of pelvic sepsis. The scale does NOT replace mandatory digital rectal exam and rigid proctosigmoidoscopy in suspected cases. Hemodynamic instability takes precedence over detailed grading.