Abdominal Trauma


Blunt

Penetrating

Thoraco-abdominal Trauma

 


Abdominal Trauma

General Rules

Blunt Trauma Penetrating Trauma
Stable
Unstable
Gun Shot
Stab
CT Acute Abdomen
No-Actue abdomen
Above
Nipple

BELOW
Nipple

Stable

UNstable

SURGERY

R/O Bleed

FAST (US)

Tx as
Chest
Trauma

SURGERY

Digital
Exploration

SURGERY

(+) Bleed (-) Bleed
SURGERY ANGIOGRAM
(for roadmap)

PELVIC TRAUMA

Hematoma

Fracture
Fracture
+
Bleeding
(-)Expanding
(+)Expanding
R/O:
- Urethral injury in Men (Retrograde Urethrogram)
- Bladder Injury (Retrograde Cystogram)
- Rectal injury
- Vaginal injury

FAST (US)

(+) BLEED
(-) BLEED

Do NOTHING

Arteriographic Embolectomy

vs

External Fixation

Arteriographic Embolectomy

vs

External Fixation

DO NOTHING

 

GENITOURINARY TRAUMA

PENETRATING
BLUNT
SURGERY Pelvic Fracture Scrotal
Hematoma
Rib
Fracture
Uretheral Bladder Testical Below Nipple
Anterior
Posterior

- Pain radiating to shoulder

    

Retrograde Cystogram
  +
Post-void films

  

SURGERY

Swollen
Normal

R/O:
- Kidney injury (CT-Scan)

SURG.

- Pt wants to void but Can't
- HIGH ridding prostate
    
1. NO FOLEY
    
2. Retrograde
Urethrogram

3. Suprapubic Drain & Delay Surgery
 

1. US
(+)
Rupture:
SURGERY

(-) Rupture:
NOTHING

NOTHING