Motor vehicle collisions are a common source of blunt abdominal trauma. Such management is a safer, successful, and more cost. Conservative management and outcome of blunt trauma abdomen. A retrospective analysis based on existing, diagnostic ct scan reports taken during a 5 year period from 245 consecutive patients with blunt abdominal trauma. Computed tomography is the gold standard for diagnosis of abdominal injuries in patients of trauma. The double jeopardy of blunt thoracoabdominal trauma trauma. Evaluation of abdominal trauma american college of surgeons. Complications may include blood loss and infection. The patterns of chest injury are highly dependent on the intensity of the trauma and.
This force blunt trauma to the abdomen has the tendency to be lifethreatening because many of the abdominal organs, especially those that reside in the retroperitoneal space, will bleed heavily in this type of injury. Get a printable copy pdf file of the complete article 1. Blunt trauma is most commonly due to motor vehicle accidents and is a major cause of morbidity and mortality in all age groups. Trauma is one of the common causes of death, and is a major economic and health problem. The close proximity of organs within the torso makes distinguishing. Blunt abdominal trauma bat represents 75% of all blunt trauma and is the most common example of this injury. Mdct is the gold standard imaging modality for severe blunt abdominal trauma. An audit of management of cases of blunt trauma abdomen. There are a wide variety of complex structures in each of these areas each with their own unique problems when injured. Blunt trauma knowledge for medical students and physicians.
Table diagnostic modalities in abdominal trauma peritoneal lavage ultrasound ct scan use records intraabdominal haemorrhage in stableunstable trauma reveals intraabdominal haemorrhage in stable and unstable in patients reveals organ of injury and extent of bluntpenetrating abdominal trauma in stable patients contraindications urgent demand. Abdominal cavity thoracic abdomen liver, spleen, diaphragm, stomach the ribs provide some protection although the organs are vulnerable to both blunt and penetrating trauma. Injuries in the abdomen occur from direct forces causing compression or shearing type injuries or deceleration injuries that. The majority occurs in motor vehicle accidents, in which rapid deceleration may propel the driver into the steering wheel, dashboard, or seatbelt causing contusions in less serious cases, or rupture of internal organs from briefly increased intraluminal pressure in the more serious. The concern is that this free fluid represents a sign of occult traumatic abdominal organ injury such as. Blunt abdominal trauma see the image below is a leading cause of morbidity and mortality among all age groups. Injuries to the small intestine are particularly worrisome because symptoms may not appear for hours, days, or even weeks. Abdominal trauma, especially those caused by blunt force is a leading cause of morbidity and mortality in all age groups, but it is one of the most challenging conditions emergency department physicians encounter because of varied presentations. The abdomen is the third most affected region in blunt trauma and major traumatic injury may not be recognized quickly enough and it becomes a cause of. Abdominal trauma blunt benign articles mount nittany. Early laparotomy is recommended for these patients. Utility of the cardiac component of fast in blunt trauma. Injuries in the abdomen occur from direct forces causing compression or shearing type injuries or deceleration injuries that result in damage to relatively fixed structures. Following blunt abdominal trauma, bowel injuries are often missed on admission computed tomography ct scan.
Trauma is a leading cause of morbidity and mortality in children. There was an 80% increase in the incidence of blunt abdominal trauma when compared with the preceding 15year experience. The nature and severity of abdominal injuries vary widely depending on the mechanism and forces involved, thus generalizations about mortality and need for operative repair tend to be misleading. Organs such as your pancreas, liver, spleen, or bladder may be injured. Abdominal trauma in children is usually due to motor vehicle accidents or falls, but child abuse is also a common cause. Occult bowel injury after blunt abdominal trauma the american. Jan 23, 2011 table diagnostic modalities in abdominal trauma peritoneal lavage ultrasound ct scan use records intraabdominal haemorrhage in stableunstable trauma reveals intraabdominal haemorrhage in stable and unstable in patients reveals organ of injury and extent of blunt penetrating abdominal trauma in stable patients contraindications urgent demand. Treatment of blunt abdominal trauma begins at the scene of the injury and is continued upon the patients arrival at the emergency department ed or trauma center. Jan 02, 2019 treatment of blunt abdominal trauma begins at the scene of the injury and is continued upon the patients arrival at the emergency department ed or trauma center. Pdf recognising and assessing blunt abdominal trauma. Citescore values are based on citation counts in a given year e. Risk factors for mortality in blunt abdominal trauma with surgical. Combat wounds are often a combination of blunt trauma and penetrating trauma.
Blunt abdominal trauma the royal melbourne hospital. The clinical evaluation of children with potential blunt abdominal injury presents a challenging task. Hepatic injuries in blunt trauma abdomen 522 p j m h s vol. Anil haripriya introduction motor vehicle accidents are responsible for 75% of all blunt trauma abdominal injuries more common in elderly due to less resilience. The most common signs of significant abdominal trauma are pain, gastrointestinal hemorrhage, hypovolemia, and peritoneal irritation. Blunt abdominal trauma is one of the important components of poly trauma. In our study conservative management of bta was found highly successful. The role of focused abdominal sonography in assessment of organ injury and reducing the need for ct. Le damage control en traumatologie abdominale severe.
Abdominal trauma, blunt answers are found in the 5minute emergency consult powered by unbound medicine. The concern is that this free fluid represents a sign of. Signs and symptoms include abdominal pain, tenderness, rigidity, and bruising of the external abdomen. Blunt trauma of the abdomen in children astm international. It requires suspicion, investigation and proper management in. Isolated free fluid in trauma radiology reference article. Evaluation of abdominal trauma american college of.
The traditional teaching was that all penetrating trauma of the abdomen should be explored, whereas blunt injury could be observed as the incidence of bowel injury was much lower 1. Diagnosis and management of blunt abdominal trauma. Algorithm for management of blunt abdominal trauma. Jan 02, 2019 blunt abdominal trauma see the image below is a leading cause of morbidity and mortality among all age groups. Blunt injuries causes solid organ trauma spleen, liver and kidneys more often than hollow viscera. One of the most lethal mechanisms of injury is shotgun wound and particularly the abdominal one. The lack of historical data and the presence of distracting injuries or altered mental status, from head injury or intoxication, can make these injuries difficult to diagnose and manage. Identification of serious intraabdominal pathology is often challenging. The management of the abdominal shotgun wounds is mainly dependent on clinical examination and clinical judgment, while requires advanced surgical skills.
These injuries are caused by car accidents, sports injuries, or a fall. The double jeopardy of blunt thoracoabdominal trauma. However, the signs of an internal injury may take more time to appear. Algorithm for management of blunt abdominal trauma authorstream. The abdomen can be injured in many types of trauma. Many serious abdominal injuries may appear insignificant, making it extremely difficult to predict severity. The abdomen is the third most common injured region, in 25% of cases who require surgical interference.
Based on your visit today, your condition does not seem serious. Any intraperitoneal organ may be ruptured without superficial evidence of trauma. Retroperitoneal abdomen kidneys, ureters, pancreas, duodenum organs are generally better. Clinical profile and aids to diagnosis and management of. Blunt abdominal trauma is regularly encountered in the emergency department ed. We report a case of a 45 years old male suffering abdominal shotgun trauma, who survived his injuries. Blunt abdominal trauma accounts for more than half the cases of abdominal trauma here. In the united states, trauma is a serious health problem, both as a cause of mortality and as a significant financial burden. The abdomen is the second most common site of injury. Penetrating and blunt trauma to the abdomen can produce significant and lifethreatening injuries.
Blunt trauma includes direct blows, crushing injuries, blast and deceleration forces. This article discusses abdominal trauma in children. So, be alert for any new symptoms or worsening of your condition. The presence of isolated free fluid in trauma occurs in 35% of blunt trauma patients 14 pathology. The signs of blunt abdominal trauma include hypotension, tachycardia, abdominal tenderness, and rigidity and the symptom include abdominal pain and bruising. Contusion abdominale, traitement non operatoire, hemoperitoine. Abdominal trauma is classified as either blunt or penetrating.
When evaluating a patient for abdominal trauma, it is necessary to think of the abdomen as three separate areas, which consist of the peritoneal cavity, pelvis, and the retro peritoneum. The close proximity of organs within the torso makes distinguishing between abdomen, chest and pelvic injuries difficult. Management may involve nonoperative measures or surgical treatment, as appropriate. Pdf on sep 20, 2017, alabousi a and others published blunt abdominal trauma. Falling from height, direct hit to the abdomen, fight, football, and crushing are other causes of blunt abdominal trauma. Abdominal trauma continues to account for a large number of traumarelated injuries and death.
Findings of abdominal trauma haemoperitoneum splenic trauma. Blunt abdominal trauma journal major trauma causes of. A3xa traumatic compartment syndrome of abdomen, initial encounter. The finding of more than trace amounts of free fluid in the absence of solid organ injury in bat is often associated with clinically significant visceral injury. Recognising and assessing blunt abdominal trauma article pdf available in emergency nurse. Abdominal trauma continues to account for a large number of trauma related injuries and death. Appropriate and expeditious investigation facilitates definitive management and minimises the risk of complications, so it is crucially important. The difference in severity between presenting symptoms and actual injuries in a significant number. Blunt trauma abdomen operative vs conservative management dr. Abdominal trauma is usually divided into blunt and penetrating trauma. Traumatic compartment syndrome of abdomen icd10cm diagnosis code t79. A blunt abdominal injury is a direct blow to the abdomen without an open wound. Traumatic lacerations to the right and left liver lobes arrows, image 1a and pancreas image 1b, arrow with left renal pedicle injury lack. Initial evaluation of children sustaining blunt abdominal trauma.