OnlineMedEd: Surgery: Trauma - "Abdomen"

Question 1

In the case of ____________, the patient must go to the OR.

Answer 1

peritoneal penetration

Question 2

Explain the workup of superficial abdominal wounds.

Answer 2

If you examine it and it clearly does not penetrate the peritoneum, then you can manage with observation and imaging. Otherwise, go to the OR.

Question 3

For blunt abdominal trauma, the correct imaging choices are ________________.

Answer 3

FAST exam and CT

KUB is only useful for air which is only one part of the workup (which will be seen on CT).

Question 4

The most common source of bleeding in blunt abdominal trauma is ____________.

Answer 4

the liver (spleen is second)

The ligamentum teres holds it in place while the rest of it keeps moving, causing shearing forces.

Question 5

If you can’t see what’s going on in a liver bleed, try the ___________ maneuver.

Answer 5

pringle (pressing on the pancreaticoduodenal ligament to compress the blood supply to the liver)

Question 6

Liver lacerations are generally repaired with ____________.

Answer 6

lobectomies if primary ligation fails

Question 7

Bowel sounds in the chest are suggestive of _____________.

Answer 7

ruptured diaphragm (diagnose with CT)

Question 8

Air under the diaphragm (on a KUB) is suggestive of ____________.

Answer 8

GI perforation

Question 9

In a CT, free air will be in ______________.

Answer 9

the top of the belly beneath the umbilicus (because the patient is supine)

Question 10

Counter to what you might expect, treat pelvic fracture with bleeding with ________________.

Answer 10

external fixation

Question 11

Ureteral injury (suggested by acute hydronephrosis after a trauma) should be evaluated with ______________.

Answer 11

IV pyelogram