L9: Abdominal and Pelvic Trauma Flashcards
Level of the Transtubercular Plane?
L1
Level of the Tranpyloric Plane?
L5
Level of the Supracristal Plane?
L4 (Marks end of abdominal aorta)
Organs most commonly injured by blunt trauma?
spleen > liver >intestines
Organ most commonly injured by penetrating injury?
Small bowel most commonly injured
Injuries associated with seatbelts?
Lap Belt: 30% chance of mesenteric or intestinal injury
Cross Chest: Broken ribs/ fracutred sternum
Abdominal Palpation Signs
- ______: haemorrhage
- _________________: hepatic or splenic injury
- ____________: ruptured viscus with leakage
- Fullness: haemorrhage
- Crepitation of lower rib cage: hepatic or splenic injury
- Peritonism: ruptured viscus with leakage (parietal peritoneum is irritated/inflamed => in contact w. bile or blood)
What are these signs called?
What are they indicative of?
Signs of Retroperitoneal Hemorrhage:
Excessive drinking=> Acute hemorrhagic pancreatitis => blood tracts to either flanks (Grey Turner’s Sign) or umbilicus (Cullen’s Sign)
When to operate on splenic injury?
Non-operative
- Grades I to III and hemodynamically stable
- Cat-like vigilance: serial exams follow [Hb]
- Embolize splenic vessels (IR)
Must operate (Hemodynamically Unstable)
- Ruptured Hematoma
- Hilar Vascular Injury => Devascularizartion
- Grade III Shattered Spleen
Common intestinal injury in High-speed decelerations?
Most common site?
Bucket Handle tear of Small Intestine Mesentery
- Proximal ileum is most common site
- Usually a seat belt sign+
Flexion-Distraction fracture of lumbar vertebrae is also known as?
There is a high risk of ______ and ______ injury with this fracture. How to tell?
Chance Fracture of Spine or Seatbelt Fracture
There is a high risk of pancreas and duodenal injury with a Chance fracture. Check for retroperitoneal hemorrhage
When to perform an Emergency laparotomy?
- Peritonism: vomiting, pain assc with inflammation of abdominal viscera
- Free air
- Evisceration: Ejection of internal organs
- Hypotension
- Gunshot wound traversing peritoneum
What is this?
Pneumoperitoneum: Free air under diaphragm
Signs seen in Pneumoperitoneum?
Signs seen from free fluid in the peritoneal cavity?
Pouch of Morrison: posterior right subhepatic space
Pouch of Douglas: Retrouterine Pouch
Indications for urethrogram?
DO NOT insert urthrea catheter is rupture is suspected
Vulval/scrotal hemorage
Blood at meatus
High riding prostate
Butterfly sign
What to be cautious of when repairing inguinal hemorrhage?
