Search for content here...
    

Abdominal Trauma

ABDOMINAL TRAUMA

Blunt

  • Compression or crush
  • Seat belt
  • Acceleration/deceleration

Penetrating

  • Penetrating
  • Gunshot wounds
  • Stab wounds

Deep or fixed penetrating foreign bodies should be removed only under controlled conditions in theatre

  • 20% of patients with acute traumatic hemoperitoneum have no initial signs of peritoneal irritation
  • The importance of repeated abdominal examinations cannot be overstressed
  • Intra-abdominal bleeding, gastrointestinal perforation may be present without external evidence
  • Suspect intra-abdominal bleeding in multiple trauma, especially if there is unexplained hypotension

ABDOMINAL TRAUMA IN CHILDREN

  • Blunt and penetrating injury to abdomen may injure a variety of organs
  • Splenic injuries from blunt injury especially common
  • Assume that penetrating wound to the abdominal wall has entered the abdominal cavity and that there are injuries to abdominal organs

ABDOMINAL TRAUMA: Pregnant Woman

  • Risk of:
      - Uterine irritability
      - Premature labor
      - Incomplete, complete uterine rupture
      - Placental separation (may occur up to 48 hours after injury)
      - If pelvic fracture present, severe blood loss potential
  • Splenic injuries from blunt injury especially common
  • Assume that penetrating wound to the abdominal wall has entered the abdominal cavity and that there are injuries to abdominal organs
  • ABCDE
  • Resuscitate in left lateral position to avoid aortocaval compression. Tilt the patient to the left.
  • Vaginal examination with speculum for bleeding, cervical dilatation
  • Record fundal height, note any tenderness
  • Record, monitor fetal heart rate
  • Consideration of pregnancy should always be given to any woman of childbearing age
  • Pregnant patient at term can usually be effectively resuscitated only after delivery
  • If mother and child are both critically ill, it is your clear duty to attend to the mother first
  • Best treatment for the fetus is resuscitation of the mother
© Copyright 2020 WHO