Presentations - Abdominal Trauma

Question 1

What is the death distribution following trauma? (3)

Answer 1

TRIMODAL :

1. Immediately - CNS injury, cardiac or great vessel damage.
2. Early Hours : phenomena e.g. splenic rupture, subdural haematomas, haemopneumothoraces.
3. Days : Sepsis, Multi-Organ Failure.

Question 2

Aetiology of Abdominal Trauma.

Answer 2

Common - Deceleration Injury.

Question 3

Types of Trauma and Structures (3).

Answer 3

1. Blunt - Spleen Commonest.
2. Stab - Transverse Structures e.g. Liver Commonest.
3. Gunshot - Small Bowel Commonest.

Question 4

Investigations of Abdominal Trauma (3).

Answer 4

1. Diagnostic Peritoneal Lavage.
2. Abdominal CT Scan.
3. Ultrasound Scan.

Question 5

Diagnostic Peritoneal Lavage :-

• Indication.
• Advantages.
• Disadvantages.

Answer 5

Indication : Document bleeding if hypotensive.
Advantage : Early diagnosis, sensitive and accurate.
Disadvantage : Invasive and can miss retroperitoneal + diaphragmatic injury.

Question 6

Abdominal CT Scan :-

• Indication.
• Advantages.
• Disadvantages.

Answer 6

Indication : Document organ injury if normotensive.
Advantage : Specific for localising injury.
Disadvantage : Contrast, Time and Logistics.

Question 7

Ultrasound Scan :-

• Indication.
• Advantages.
• Disadvantages.

Answer 7

Indication : Document fluid if hypotensive.
Advantages : Early diagnosis and non-invasive.
Disadvantages : Operator dependent and can miss retroperitoneal injury.