Abdominal Trauma Overview


  • Two mechanisms

  • Blunt Trauma


    Penetrating 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