Different Modalities of Management of Blunt Abdominal Trauma
Abdelsadek Lotfy Abdelsdek Abozaid;
Abstract
Blunt abdominal trauma continues to be the most common cause of injury to the abdomen.It may result from motor vehicle crashes, pedestrians struck by a motor vehicle, assaults and falls.
Abdominal trauma may result in a variety of intra-abdominal and retro-peritoneal injuries ranging from innocuous to life-threatening. The spleen is the most frequently injured organ, the liver, kidneys, small and large intestines are the next most injured organs, respectively.
Failure to early recognize intra-abdominal hemorrhage and to successfully control bleeding from intra-abdominal organs leads to significant morbidity and mortality.The detection of intra-abdominal injuries begins with understanding of trauma mechanisms, physical examination findings with maintaining a high index of suspicion, and diagnostic testing.
Several trauma scoring systems are used for facilitating the decision-making process, documentation and epidemiology, quality of care and patient outcome evaluation and injury severity description. They are based predominantly on anatomic and physiologic data.
According to advanced trauma life support (ATLS) system initial management of patients with blunt abdominal trauma aims to identify and correct any immediate life threatening condition.Priorities include airway, cervical spine contour, breathing, circulation and hemorrhage control, dysfunction of the central nervous system and exposure of the patient. After thatthe attention is directed to the secondary survey to identify all additional pathology.
Physical examination remains the initial step in diagnosis and must be done for every part of the body, but it is unreliable and has limited utility under select circumstances (e.g. altered mental status or spinal cord injury). Thus, various diagnostic modalities such as laboratory investigations CT, focused abdominal sonography for trauma (FAST), diagnostic peritoneal lavage (DPL) and diagnostic laparoscopy have evolved to offer a means to accurate diagnosis. The specific tests selected are based on the clinical stability of the patient, the ability to obtain a reliable physical examination and the provider’s access to a particular modality.
Laboratory tests are of value in the evaluation of a patient with abdominal trauma include haematocrit, urine analysis and serum amylase.
Abdominal trauma may result in a variety of intra-abdominal and retro-peritoneal injuries ranging from innocuous to life-threatening. The spleen is the most frequently injured organ, the liver, kidneys, small and large intestines are the next most injured organs, respectively.
Failure to early recognize intra-abdominal hemorrhage and to successfully control bleeding from intra-abdominal organs leads to significant morbidity and mortality.The detection of intra-abdominal injuries begins with understanding of trauma mechanisms, physical examination findings with maintaining a high index of suspicion, and diagnostic testing.
Several trauma scoring systems are used for facilitating the decision-making process, documentation and epidemiology, quality of care and patient outcome evaluation and injury severity description. They are based predominantly on anatomic and physiologic data.
According to advanced trauma life support (ATLS) system initial management of patients with blunt abdominal trauma aims to identify and correct any immediate life threatening condition.Priorities include airway, cervical spine contour, breathing, circulation and hemorrhage control, dysfunction of the central nervous system and exposure of the patient. After thatthe attention is directed to the secondary survey to identify all additional pathology.
Physical examination remains the initial step in diagnosis and must be done for every part of the body, but it is unreliable and has limited utility under select circumstances (e.g. altered mental status or spinal cord injury). Thus, various diagnostic modalities such as laboratory investigations CT, focused abdominal sonography for trauma (FAST), diagnostic peritoneal lavage (DPL) and diagnostic laparoscopy have evolved to offer a means to accurate diagnosis. The specific tests selected are based on the clinical stability of the patient, the ability to obtain a reliable physical examination and the provider’s access to a particular modality.
Laboratory tests are of value in the evaluation of a patient with abdominal trauma include haematocrit, urine analysis and serum amylase.
Other data
| Title | Different Modalities of Management of Blunt Abdominal Trauma | Other Titles | إصابـات البطـن الغــير نافـــذة الأنمـاط المختلفة للتشخيص والعـلاج | Authors | Abdelsadek Lotfy Abdelsdek Abozaid | Issue Date | 2014 |
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