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SURGICAL DISEASES > TH6 ABDOMINAL TRAUMA > Flashcards

TH6 ABDOMINAL TRAUMA Flashcards

1
Q

PENETRATING ABDOMINAL TRAUMA

A

INJURY WHEN OBJECT PIERCES PARIETAL PERITONEUM + ENTERS PERITONEAL CAVITY

CAUSE:
> laceration of solid organs
> perforate hollow organs > must be discovered + repaired in laparotomy

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2
Q

BLUNT ABDOMINAL TRAUMA

A

TRAUMATIC OBJECT DOESN’T PIERCE PARIETAL PERITONEUM + SKIN IS NOT BROKEN

CAN CAUSE:
laceration of solid organs + bleeding
hemorrhagic shock + perforation

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3
Q

MANAGEMENT OF BLUNT TRAUMA WHO ARE UNSTABLE TO SEE W/ INTRABDOMINAL FLUID ON FAST?

A

LAPARATOMY

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4
Q

WHAT IS FAST?

A

FOCUSED ASSESSMENT WITH SONOGRAPHY IN TRAUMA

  • rapid bedside ultrasound examination
  • test for blood around heart (pericardial effusion)
  • blood around abdominal organs (hemoperitoneum)
  • after trauma
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5
Q

EVLUATION METHOD FOR PX WITH BLUNT TRAUMA + MENTAL STATUS + CONCOMITANT INJURIES + NO AVAILABLE FAST?

A

PERITONEAL LAVAGE

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6
Q

MANAGEMENT OF ANTERIOR ABDOMINAL WALL GUNSHOT?

A

LAPARATOMY

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7
Q

MANAGEMENT OF STAB WOUNDS WITH PERITONITIS, EVISCERATION/ UNSTABLE HEMODYNAMICS?

A

LAPARATOMY

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8
Q

PRINCIPLE OF EMERGENT LAPARATOMY IN ABDOMINAL TRAUMA?

A

SYSTEMIC EXPLORATION

- so all areas of abdomen is assessed + injuries not missed

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9
Q

STANDARD TECHNIQUE FOR OPENING ABDOMEN IN EMERGENCY LAPARATOMY?

A

Abdomen opened from xiphoid process > pubic symphysis to provide adequate exposure of all abdominal structures

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10
Q

MC SOLID ORGAN INJURIED IN BLUNT TRAUMA?

A

SPLEEN

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11
Q

MC CAUSE OF SPLEEN INJURY?

A

ROAD + SPORT ACCIDENT

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12
Q

DEFINE DELAYED RUPUTRE OF SPLEEN?

A

OCCURS WHEN CLINICAL SIGNS OCCUR AFTER 48hrs FROM INITIAL INJURY

DUE: tearing of capsule due to expansion of sub capsular hematoma

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13
Q

KEHRS SIGN?

A

PAIN IN TIP OF LEFT SHOULDER

DUE: irritation of undersurface of diaphragm by blood in peritoneal cavity (leak by injured spleen)

> STIMUALTE PHRENIC NERVE - C4 dermatome

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14
Q

IN WHAT INJURY IS KEHRS SIGN POSITIVE?

A

INJURY + RUPTURE TO SPLEEN

> leak of blood into peritoneal cavity + stimulating phrenic nerve + irritation of undersurface of diaphragm

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15
Q

WHY IS LIVER INVOLVED IN ABDOMINAL TRAUMA?

A

> LIVE SIZE
ANATOMICAL LOCATION
directly under right costal margin
frequently involved penetrating trauma

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16
Q

PRESENTATION OF INTRA ABDOMINAL BLEEDING?

A

ABDOMINAL PAIN
TENDERNESS
GUARDING
RIGIDITY

17
Q

HEMOBILLIA?

A

GI haemorrhage caused by bleeding into billiary tree

sign of extensive liver haemorrhage

18
Q

TYPE OF ABDOMINAL TRAUMA AFFECTING STOMACH MOST?

A

PENETRATING TRAUMA

> full thickness perforation > resulting in spillage of gastric contents > peritonitis

19
Q

PRESENTATION OF GASTRIC INJURIES WITH FULL THICKNESS PERFORMATION OF STOMACH PERITONTIS?

A

PERITONITIS

> due to peritoneal irritation from intra peritoneal leakage of low pH content of stomach (acidic)

20
Q

WHY ARE PHYSICAL FINDING LIMITED IN DUODENAL INJURY?

A

DUE: RETROPERITONEAL LOCATION OF SIGNIFICANT PORTION OF DUODENUM

21
Q

WHY IS DUODENAL INJURY OFTEN ASSOCIATED WITH PANCREATIC INJURY?

A

ADJACENT LOCATION

22
Q

WHY DOES PANCREAS INJURY HAVE HIGH MORTALITY?

A

DELAY IN DIAGNOSIS + TX

CAUSTIC NATURE OF PANCREATIC ENZYMES

DELAY IN DX > results in massive systemic inflammation > leading to poor outcome

23
Q

MOST COMMON MECHANISM FOR PANCREATIC TRAUMA?

A

CRUSHING BODY BETWEEN RIGID STRUCTURE ( STEERING WHEEL, SEATBELT) + VERTEBRAL COLUMN

cause injury to pancreas > ranging from mild contusion to complete transection with ductal disruption

24
Q

TYPE OF TRAUM SMALL INTESTINE ASSOCIATED WITH?

A

PENETRATING ABDOMINAL TRAUMA

25
Q

PRESENTATION OF SMALL INTESTINE INJURY WITH PERFORATION?

A 
SMALL INTESTINE TRAUMA WITH FULL THICKNESS PERFORATION:
> signs of peritoneal irritation 
> abdominal pain 
> tenderness
> guarding + rigidity
26
Q

TYPE OF TRAUMA COLON/ RECTAL INJURY ASSOCIATED WITH?

A

PENETRATING ABDOMINAL TRAUMA

RARELY > BLUNT TRAUMA

27
Q

WHAT DOES BLOOD ON RECTAL EXAMINATION MEAN?

A

RECTAL INVOLVEMENT + REQUIRES FURTHER EVALUATION

SURGICAL DISEASES (13 decks)

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