Abdominal Trauma, Penetrating, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Solid organ injury usually results in hemorrhage.

  • Hollow viscus injury can lead to spillage of bowel contents and peritonitis.

  • Associated conditions:

    • Injury to both thoracic and abdomin...

Diagnosis

Signs and Symptoms

  • Penetrating wound from knife, gun, or other foreign object

  • Spectrum of presentation ranging from localized pain to peritoneal signs:

    • High-velocity projectile can cause extens...

Treatment

Pre-Hospital

  • Controversies:

    • Military antishock trousers (MAST) should not be used.

    • Titrate fluid resuscitation to clinical response.

  • Caution:

    • Apply sterile dressings to open wounds and moistened ...

Follow-Up

Disposition

Admission Criteria

  • Patients requiring abdominal surgery

  • Observe the following patients for at least 8 hr:

    • Patients with negative findings on diagnostic peritoneal lavage, CT, or US. ...

Pearls and Pitfalls

Permissive hypotension is gaining support as a resuscitative principle: 
  • Avoid normal or near normal BP.

  • Avoid overaggressive resuscitation with crystalloids.

  • Completely exposing the ...

Additional Reading

  • Goodman  CS, Hur  JY, Adajar  MA, et al. How well does CT predict the need for laparotomy in hemodynamically stable patients with penetrating abdominal injury? A review and meta-ana...

Codes

ICD9

868.10 Injury to other intra-abdominal organs with open wound into cavity, unspecified intra-abdominal organ 

ICD10

  • S31.609A Unsp opn wnd abd wall, unsp quadrant w penet perit cav, init

  • S31.639...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×