Abdominal Trauma

1
Abdominal Trauma

• Causes and Forms
• Cold weapon, stab
• Firearm, gunshot
• Blunt, assault
• Psychology problen

2

• Causes and Forms
• penetrating
• blunt
• Coincidence injuries

3
Presentation

• History
• Collect information from bystander and patient
• Injury circumstance
• Agent ?Time ?position
• Presentation
• Pain ?vomiting ?throw up blood ?blood in
  stool?hematuria, wound outflow

4
Assessment

• Mechanism of injury
• blunt (assault, seat belt)
• penetrating (knife, GSW)

5
Assessment

• Inspection
• abdomen, flanks, back
• ecchymosis or puncture wounds
• LUQ spleen
• umbilicus or flank retroperitoneal bleed

6
Physical examination

• General condition
• Apathy, pale ?cold extremities and
  sweatiness-indicate shock.
• Fever -infection in peritoneum

7

• Pulse and Blood pressure
• Tackycardia, normal pressure or slightly elevate
• tachycardia ,lower pressure
• Normal pules rate and pressure,suddenly change
  some days later

8

• Chest examination
• Skin bruits, gore, ribs rupture?Bowel sound in
  chest indicate the rupture of diaphragm or
  diaphragmatocele

9
Physical Exam

• Auscultation
• auscultate before palpating or percussing
• listen to all quadrants
• check for bruits, or friction rubs

10
Physical Exam

• Percussion
• hyperresonance occurs with increased air in
  cavity
• dullness occurs with blood in cavity

11
Physical Exam

• Palpation
• involuntary guarding, rigidity, localized pain
  rebound tenderness
• masses in upper quads