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Abdominal Trauma, Blunt, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Injury results from a sudden increase of pressure to abdomen.

  • Solid organ injury usually manifests as hemorrhage.

  • Hollow viscus injuries result in bleeding and peritonitis from contami...

Diagnosis

Signs and Symptoms

  • Spectrum from abdominal pain, signs of peritoneal irritation to hypovolemic shock

  • Nausea or vomiting

  • Labored respiration from diaphragm irritation or upper abdominal injury

  • Le...

Treatment

Pre-Hospital

  • Titrate fluid resuscitation to clinical response. Target SBP of 90–100 mm Hg

  • Normal vital signs do not preclude significant intra-abdominal pathology.

Initial Stabilization/Therapy

  • ...

Follow-Up

Disposition

Admission Criteria

  • Postoperative cases

  • Equivocal findings on diagnostic peritoneal lavage, FAST exam, or CT

  • Many blunt abdominal trauma patients benefit from admission, monitoring, a...

Pearls and Pitfalls

  • Do not delay blood products when patient is in obvious shock despite normal Hct.

  • Avoid overaggressive resuscitation with crystalloids.

  • Obtain a pregnancy test in all females of child...

Additional Reading

  • Amoroso  TA. Evaluation of the patient with blunt abdominal trauma: An evidence based approach. Emerg Med Clin North Am.  1999;17:63–75.

  • Holmes  JF, Offerman  SR, Chang  CH, et ...

Codes

ICD9

  • 459.0 Hemorrhage, unspecified

  • 865.00 Injury to spleen without mention of open wound into cavity, unspecified injury

  • 868.00 Injury to other intra-abdominal organs without mention of open wound ...

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