Abdominal Trauma Flashcards
How common is abdominal trauma in major trauma case?
Present in 1/5 major trauma patients
What percentage of serious abdominal injuries will go undetected in early stages?
25% or up to 50% I the person is unconscious.
Would you expect to see abdominal distension or changes in girth in an abdominal injury?
You may but these are really seen even with a massive heammorage.
Would you expect to see abdominal distension or changes in girth in an abdominal injury?
You may but these are really seen even with a massive heammorage.
What are the solid organs o the abdomin
Liver, Spleen, Kidneys, pancreas
What are the soft/hollow organs o the abdomin?
Stomach, intestines, bladder, uterus/reproductive, gall blader
What are the boundaries of the abdominal cavity?
Diaphragm anterior abdominal wall Pelvic skeletal structures vertebral column muscles of the abdomen and flanks
What organs are present in the right hypochondriac region?
Liver, gall bladder, small onetime, ascending colon, transverse colon and right kidney
What organs are present in the right hypochondriac region?
Liver, gall bladder, small onetime, ascending colon, transverse colon and right kidney
What organs are present in the epigastric region?
stomach, tip o liver, tail of pancreas, small inststine, transverse colon, right and left adrenal glands, right and let kidneys, right and left ureters and spleen
what organs are present in the left hypochondriac region?
Stomach, small intestines, transverse colon, pancreas, let kidney, spleen, depending colon
What organs are present in the right lumbar region?
Liver, gall bladder, small intestine, acesding colon, tip o right kidney
What organs are present in the umbilical region?
Stomach, pancreas, small intestine, transverse colon, pancreas, right and let indues, right and let ureters
What organs are present in the left lumbar region?
Small intestine, decesding colon, tip of left kidney
What organs are present in the right iliac region?
Small inestine, appendix, cecum and accesending colon
F- right ovary and right fallopian tube
What is present in the hypogastric region?
small intestine, sigmoid colon, rectum, left and right ureters, bladder
F- uterus, right and let ovaries and fallopian tubes
M- Vas diference, seminal vessile and prostate
What is in the left iliac region?
Small intestine, depending colon and sigmoid colon
F- left ovary and Fallopian tube
What organs are in the retroperitonium? What does this mean?
Kidneys, uterus, inferior vena cava, abdominal aorta, pancreas, bladder and part of oesophagus
They are not specifically delineated by any abdominal structure. There are lined by peritoneum only on their anterior side.
What is the definition of visceral pain?
Caused by the stretching of fibres in. walls/capsules of hollow/solid organs
What nerves are invigorated causing visceral pain?
Afferent fibres involved in visceral pain are unmylinated C-fibers that enter the spinal chord bilaterally, resulting in dull and poorly localised pain
What is the presentation of visceral pain?
Pain ranges from ache or vague discomfort to excruciating or colicky pain
can be present along the midline
May be referred
May have sweating, nausea, vomiting and tachycardia
What is parietal pain?
Irritation of nerves in the parietal peritoneum usually anterior abdominal wall
What is parietal pain aggravated by and how does it present?
Respiration, thoracic and abdominal movements can aggravate. And presents as Sharp and localised constant pain
Guarding, legs rain and decreased movement and localised peritonitis develops rigidity and tenderness occurs
What are Khers sings?
Occurrence of acute pain at the shoulder tip due to the presence of blood or other irritant in the peritoneum irritating the diagram when the paitent is supine
Left shoulder pain is an indication of a ruptured spleen.
What are cullers signs?
Bruising around the belly button
What are grey turners sings?
Bruising on the flanks of the leg/hip
What are the risk factors for intra-abdominal injury?
High speed collision
Pedestrian impact
hypotension <100mmHg
presence of severe chest or pelvic injury
significant injuries on opposing side of abdomen
What is guarding?
Voluntary contraction of the abdominal muscles
What are the types of abdominal injuries that a person may sustain?
Hollow organ/solid organ injuries
Vascular injuries
Abdominal evisceration
Genitourinary
What are the most common causes of blunt abdominal injuries and who is most affected?
Sporting accidents, falls and assaults that cause impact the flank and right upper quadrants
Mostly seen in young men
What can major abdominal compression via a lap belt cause?
Pancreatic, duodenal or diaphragmatic ruptures.
What would you expect to cause a spleen to rupture?
How does this bleed?
How would it present?
trauma to ribs 9-11 on left side
bleeds slowly due to casual around- when capsule ruptures rapid onset of shock
Present with left shoulder pain
What often cause injury to the liver?
How does this injury usually bleed?
Injury to the 8-12 ribs on the right side
Bleeds slowly contained in its capital which then enters peritoneal cavity
How is the pancreas usually injured?
What would you expect from an injured pancreas?
Injury due to compression onto the vertebral column often by a steering wheel
Very little haemorrhage, fluid loss of pancreatic enzymes
What usually causes injury to the kidneys?
How does this present?
Direct blow to flank, back or upper abdomen
Shearing from acceleration/declaration
Presentation- heamaturia, hypovolemia and localised pain
If there is an injury to the bowls and contamination occurs what are the symptoms?
What may happen after contamination?
Pain, tenderness, guarding, and rigidity
Bacterial content causes peritonitis- inflammation may tae up to 6-8 hours to develop
If there is an abdominal evisceration what is the management?
Do not replace into abdomen
Cover exposed bowl with saline moistened multi trauma dressing
Cover first dressing in second dressing
What is primary abdominal compartment syndrome?
A process within or involving the abdominal itself leading to intra-abdominal hypertension
- heammorage/trauma
What is secondary abdominal compartment syndrome?
Intra-abdominal hypertension without direct injury- strongly related to fluid rests where infusion >3L
