Abdominal Trauma Flashcards
What is a penetrating trauma?
Stab wounds + gunshot wounds
Small intestine > colon > liver
Penetrates organs
What is blunt trauma?
Crushing effect
Ruptures/bursts hollow organs
Shearing injuries
Spleen > liver
What are the signs of an intraperitoneal injury?
Abdominal tenderness Shock Entrance/exit wounds Seat belt sign Reduced bowel sounds
DRE - blood or subcutaneous emphysema
What is the general management?
Primary survey
- Airway
- Breathing
- Circulation
- DIsability
- Exposure
Secondary survey
- Head to toe
What is FAST?
FAST = focussed assessment with sonography for trauma
Check
- perihepatic space
- hepatorenal space
- perisplenic space
- pelvis
- pericardium
What is the liver trauma scale?
Grade 1 = supcapsular haematoma OR capsular tear <1cm
Grade 2 = intraparenchymal haematoma <10cm OR capsular tear 1-3cm
Grade 3 = intraparenchymal haematoma >10cm OR capsular tear >3cm
Grade 4 = parenchymal disruption 25-75% OR active bleeding vascular injury
Grade 5 = parenchymal disruption >75% OR juxtahepatic injry
What is the spleen trauma scale?
Grade 1 = subcapsular haematoma <10% OR capsular tear
Grade 2 = subcapsular haematoma >10% OR intraparenchymal haematoma
Grade 3 = ruptured haematoma OR parenchymal lsceration >3cm
Grade 4 = splenic vascular injury
Grade 5 = shattered spleen
What is the management of penetrating trauma?
Superficial wound (not breached peritoneum) - non-operative management
Deep wound
- mandatory laparotomy
What is the management of blunt trauma?
Laparotomy
Damage control (indications: haemodynamic instability, cogaultopathy, hypothermia)
- initial resus
- control haemorrhage + contamination
- return to ICU
- definitvie repair
- definitive closure of abdomen
What is abdominal compartment syndrome?
Intra-abdominal pressure >20mmHg
Hypoperfusion of organs
