Traumatic Abdominal Injuries Flashcards
Located below the diaphragm and contains major organs of the digestive, endocrine, urogenital systems and major vessels
Abdominal cavity
Abdominal cavity is divided into what two regions?
Peritoneal cavity
Retroperitoneal space
“True Abdomen”
- Solid organs
- Portions of the large intestine
- Most of the small intestines
- Female reproductive organs
Peritoneal cavity
Area located behind the peritoneum and contains:
- Kidneys
- Ureters
- Inferior vena cava
- Aorta
- Pancreas
- Much of the duodenum
- Ascending descending colon and rectum
Retroperitoneal
The acids, enzymes and bacteria from the GI tract in an injury can result in:
Peritonitis and sepsis
Most commonly injury:
- Small bowel (50%)
- Colon (40%)
- Liver (30%)
- Abdominal vessels (25%)
GSW
___% of GSW will require surgery for definitive intervention
85%
__% of stab wounds will require surgery for definitive intervention
15%
Injuries most often involved in blunt abdominal trauma include
- Spleen 40-55%
- Liver 35-45%
- Small bowel 5-10%
The most reliable indicator of intra-abdominal bleeding is the:
Presence of hypovolemic shock from an unexplained source
Indicates sudden force from deceleration (20% chance of intra-abd injury in adults) bowel
Seat Belt Sign
Distended abdomen may result from greater than ___ L of blood or a stomach filled with air
1.5 L
Historically thought to be a strong indicator of peritonitis. Controversial – performed by deeply palpating then quickly releasing. If more pain is felt when releasing then this is a positive test.
Rebound tenderness
Auscultation
Hemorrhage or spillage of contents may result in:
Ileus (cessation of peristalsis)
Bowel sounds are heard over the thorax
Diaphragmatic injury
Significant tenderness to percussion or pain with coughing is a strong indicator for:
Peritonitis
Primary bedside modality to assess for intra-abdominal injury
Reliable, quick, repeatable, sensitive
FAST exams
Image acquisition for FAST exam
RUQ, LUQ, pelvic, pericardial
FAST exam
Can help with the subxiphoid view
Bending the knees
FAST
Cardiac view is a secondary option if unable to get the subxiphoid view
PSLA
Probe for FAST exam
Curvilinear
Phased-array
FAST
Scan planes for RUQ and LUQ
Sagittal
FAST
Scan planes for pelvic
Transverse and sagittal
FAST
Scan planes for subxiphoid or PSLA
Cardiac
