14. Guidelines for observing patient with blunt abdominal injuries, diagnosis and treatment of parenchymal and bowel injuries

Question 1

Guidelines for observing patient with blunt abdominal injuries

Answer 1

ABCDE

Question 2

diagnosis of parenchymal and bowel injuries

Answer 2

Symptoms:
• Abdominal pain
Signs:
• CULLEN
• GREY TURNER
Imaging:
• Ultrasound → free abdominal fluid (FAST)
• CT → free abdominal air

Question 3

What is the cullen sign?

Answer 3

Intraperitoneal bleeding → periumbilical bruising

Question 4

What is the grey turner sign?

Answer 4

Retroperitoneal bleeding → flank bruising

Question 5

treatment of parenchymal and bowel injuries

Answer 5

Positive FAST + peritonitis:
* EXPLORATORY LAPOROTOMY

Hemodynamic instability:
* EXPLORATORY LAPOROTOMY

Pseudoaneurysm:
* Interventional radiology

Question 6

spleen injury grading

Answer 6

1: minor subcapsular tear, hematoma
2. parenchymal injury not extending to hilum
3. major parenchymal injury involving vessels, hilum
4. shattered spleen

Question 7

if splenic conservation attemped how much of the spleen fo we have to preserve?

Answer 7

more than 20% of tissue

Question 8

complication of splenectomy

Answer 8

elevated risk of infection, mainly from encapsulated Gram-negative pathogens