AAST Kidney Injury

Question 1

Grade I

Answer 1

Subcapsular haematoma or contusion, without laceration

Question 2

Grade II

Answer 2

Superficial laceration ≤1 cm depth not involving the collecting system (no evidence of urine extravasation)

Perirenal haematoma confined within the perirenal fascia

Question 3

Grade III

Answer 3

Laceration >1 cm not involving the collecting system (no evidence of urine extravasation)

Vascular injury or active bleeding confined within the perirenal fascia

Question 4

Grade IV

Answer 4

Laceration involving the collecting system with urinary extravasation

Laceration of the renal pelvis and/or complete ureteropelvic disruption

Vascular injury to segmental renal artery or vein
segmental infarctions without associated active bleeding (i.e. due to vessel thrombosis)

Active bleeding extending beyond the perirenal fascia (i.e. into the retroperitoneum or peritoneum)

Question 5

Grade V

Answer 5

Shattered kidney

Avulsion of renal hilum or laceration of the main renal artery or vein: devascularisation of a kidney due to hilar injury

Devascularised kidney with active bleeding