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An Algorithm to Avoid Missed Bowel Injuries in Blunt Abdominal Trauma Patients
Ashley B Clement1, Logan C Gold1, Jonathan E Schoen2,3
1School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
The American Surgeon
|November 25, 2025
Summary
A new scoring system, the Abbreviated Injury Scale (AIS) Bowel Injury (AMBI) score, aids in detecting bowel injuries after blunt abdominal trauma (BAT). This tool improves diagnosis and reduces hospital stays for trauma patients.
Area of Science:
- Trauma Surgery
- Diagnostic Imaging
- Clinical Decision Support
Background:
- Bowel injuries from blunt abdominal trauma (BAT) are challenging to diagnose early.
- Delayed diagnosis of these injuries leads to increased patient morbidity and mortality.
Purpose of the Study:
- To develop a point-based scoring system for detecting bowel injuries in BAT patients.
- To reduce missed and delayed diagnoses of bowel injuries.
- To guide clinical decision-making in BAT cases.
Main Methods:
- A novel scoring system, the AMBI algorithm, was created using imaging, physical exam, and laboratory findings.
- The AMBI algorithm was piloted for 9 months at a Level I trauma center for adult BAT patients.
Main Results:
- The AMBI algorithm was evaluated in 141 BAT patients.
- Patients managed with AMBI showed a significant decrease in hospital length of stay (HLOS).
- An AMBI score of ≥1.5 strongly correlated with the presence of bowel injury, outperforming previous systems.
Conclusions:
- The AMBI score effectively aids in detecting bowel injuries in BAT patients.
- Implementation of the AMBI score led to a reduced HLOS.
- Further research is recommended to refine the AMBI score and integrate it with AI.
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