Abdominal And Pelvic Trauma

Question 1

Blunt

Answer 1

Direct blow - compression or crushing, rupture of organs
Shearing - when restraint worn inappropriately
Deceleration - Lacerations of organs

Question 2

Penetrating

Answer 2

Tissue damage by lacerating and tearing

High kinetic injury

Question 3

Blast

Answer 3

Systematic approach required

Question 4

Restraint device

Answer 4

Lap seat belt - tear of bowel / rupture of colon, chance fracture, pancreatic or duodenal

Shoulder harness - Rupture of viscera, intimately tear or thrombosis, cervical spine, rib fractures, pulmonary contusion

Air bag - face and eye abrasions, cardiac, spine injuries

Question 5

Indications for laparotomy

Answer 5

Blunt trauma with hypotension, positive fast, clinical bleed or no other source of bleeding
Hypotension with anterior fascia penetration
Evisceration
Peritonitis is
Bleeding from tracts
Free air, retroperitoneal air, rupture hemidiapragm
Contrast CT that shows injury

Question 6

Pelvic fractures

Answer 6

AP - open book - motor cycle or head on —> external rotation
Lateral compression - closed - Rotates internally -> potential injury to bladder or urethra
Vertical shear - one sided - high shear across anterior and posterior plane
- Sacrotuberous and sacrospinous ligaments