Abdominal & Pelvic Trauma

Question 1

Anatomic regions of the abdomen?

Answer 1

1. Thoracoabdominal - area inferior to the nipple line anteriorly and the infrascapular line posteriorly, and superior to the costal margins diaphragm, liver, spleen, and stomach, and is somewhat protected by the bony thorax.
2. Anterior - area between
   the costal margins superiorly, the inguinal ligaments and symphysis pubis inferiorly, and the anterior axillary lines laterally.
3. Posterior - posterior to the posterior axillary lines from the tip of the scapulae to the iliac crests. This includes the posterior thoracoabdomen.
4. Flank - area between the anterior and posterior axillary lines from the sixth intercostal space to the iliac crest.

Question 2

MOA that increases risk of abdominal & pelvic trauma?

Answer 2

1. Blunt abdominal trauma - direct blow or shearing forces .g. bucket handle
2. Penetrating trauma
   - stab wound & low energy GSW
   - High energy GSW (note: trajectory/ cavitation / bullet fragmentation)
3. Blast - combo of penetrating/ blunt and overpressure injuries e.g. TM

Question 3

Indications for laparotomy?

Question 4

Diagnostic procedures

Question 5

Acute management of ….

Question 6

Can there be no peritoneal irritation in significant blood loss?

Answer 6

Significant blood loss can be present in the
abdominal cavity without a dramatic change in the
external appearance or dimensions of the abdomen
and without obvious signs of peritoneal irritation.

Question 7

Retroperitoneal space contents?

Answer 7

abdominal aorta; inferior vena cava; most of
the duodenum, pancreas, kidneys, and ureters; the
posterior aspects of the ascending colon and descending
colon; and the retroperitoneal components
of the pelvic cavity.

Question 8

Pelvic cavity?

Answer 8

area surrounded by pelvic
bones, containing the lower part of the retroperitoneal
and intraperitoneal spaces.
Contents: bladder, iliac vessels, and female internal reproductive
organs.

Question 9

History questions

Answer 9

1. MVA
2. Fall from height
3. Penetrating trauma

Question 10

Examination

Answer 10

IPPA
Pelvis/ Buttock/ perineal
Urethral
+- vaginal
+- rectal