Trauma to Abdomen
Injuries may be blunt or
Do a diagnostic peritoneal lavage
(DPL) to look for bleeding
A surgeon must evaluate all
penetrating injuries of the abdomen.
Intra abdominal visceral damage
must be strongly suspected following blunt trauma to the abdomen. Multiple
injuries are common and signs and symptoms guide diagnosis. Note that distracting
injuries (eg fractures) may mask abdominal symptoms.
Injury penetrates peritoneum
Significant pancreatic injury on
Significant splenic injury in an
Ruptured spleen (intraperitoneal
o Signs and symptoms: May be pain free, may have signs of blood loss
o Treatment: Splenectomy if elderly otherwise try to preserve it
Ruptured liver: Treatment:
Laparotomy and suturing individual vessels/ packing etc.
Ruptured gut: Presence of gas
under diaphragm on x-ray, or history of penetrating wound needs laparotomy and
repair/resection of affected bowel