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Blunt abdominal trauma: Difference between revisions

Blunt abdominal trauma (view source)

Revision as of 10:54, 5 December 2023

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* Abdominal guarding
* Abdominal guarding


Intraabdominal bleeding can rapidly cause shock and death, and so investigations should be directed at uncovering this ASAP. The so-called [[eFAST]] (extended Focused Assessment with Sonography for Trauma) is the standard screening examination for intraabdominal free fluid (like blood), [[pneumothorax]], hemopericardium, and [[Cardiac tamponade|tamponade]]. eFAST takes only a few seconds to perform and can rapidly diagnose the mentioned conditions. However, it should be kept in mind that a negative eFAST doesn’t rule out intraabdominal injury, as eFAST cannot discern diaphragmatic tears, pancreatic injury, [[Gastrointestinal perforation|bowel perforation]], and small amounts of free fluid. The sensitivity of eFAST is also limited. The main objective of eFAST is to decrease the number of people who require a [[CT]] scan, thereby shortening their time to surgery.
Intraabdominal bleeding can rapidly cause shock and death, and so investigations should be directed at uncovering this ASAP. The so-called [[eFAST]] (extended Focused Assessment with Sonography for Trauma) is the standard screening examination for intraabdominal free fluid (like blood), [[pneumothorax]], hemopericardium, and [[Cardiac tamponade|tamponade]]. eFAST takes only a few minutes to perform and can rapidly diagnose the mentioned conditions. However, it should be kept in mind that a negative eFAST doesn’t rule out intraabdominal injury, as eFAST cannot discern diaphragmatic tears, pancreatic injury, [[Gastrointestinal perforation|bowel perforation]], and small amounts of free fluid. The sensitivity of eFAST is also limited. The main objective of eFAST is to decrease the number of people who require a [[CT]] scan, thereby shortening their time to surgery.


In case eFAST detects intraabdominal free fluid, the patient has likely suffered large injuries which require surgery, and so the patient should be taken to emergency [[laparotomy]].
In case eFAST detects intraabdominal free fluid, the patient has likely suffered large injuries which require surgery, and so the patient should be taken to emergency [[laparotomy]].
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In case eFAST does not detect any pathology, an abdominal CT scan should be performed if the risk for intra-abdominal injury isn’t low. If the abdominal CT shows injury, emergency laparotomy should be performed.
In case eFAST does not detect any pathology, an abdominal CT scan should be performed if the risk for intra-abdominal injury isn’t low. If the abdominal CT shows injury, emergency laparotomy should be performed.


Laparotomy allows for direct visualisation of all abdominal organs, providing the best visualisation of any possible injuries. It is indicated if intra-abdominal bleeding is detected (on US or CT), the patient is haemodynamically unstable, or there are signs of [[peritonitis]]. In the operating room, tears and lacerations may be sutured or compressed to stop bleeding, and injured parts of organs may be resected.<noinclude>[[Category:Traumatology]]</noinclude>
Laparotomy allows for direct visualisation of all abdominal organs, providing the best visualisation of any possible injuries. It is indicated if intra-abdominal bleeding is detected (on US or CT), the patient is haemodynamically unstable, or there are signs of [[peritonitis]]. In the operating room, tears and lacerations may be sutured or compressed to stop bleeding, and injured parts of organs may be resected.<noinclude>
[[Category:Traumatology]]
</noinclude>