Abdominal Trauma

Question 1

What is the pathogenesis of most abdominal trauma?

Answer 1

• Blunt force injuries
  
  • Differential deceleration and shear forces
    
    • Aortic root tears, renal arteries, hepatic tear along ligamentum teres
  • Crushing
    
    • Spleen, liver, kidneys
  • External compression
    
    • Hollow viscera especially vulnerable
• Penetrating injuries

Question 2

What investigations might be indicated in someone with abdominal trauma?

Answer 2

• FBE
• UEC
• Group and hold
• ABGs
• Blood EtOH
• US + XR/CT

Question 3

Outline the management prinicples for abdominal trauma

Answer 3

• Primary survey (ABCDE) and management
• Secondary survey
• Imaging
• Laparotomy if haemodynamically unstable
• Fluid resuscitation and warming