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Phase II: Periop Pt1 > Abdominal trauma > Flashcards

Flashcards in Abdominal trauma Deck (17):
1

What proportion of trauma patients present with abdominal trauma?

7-10%

2

Name 2 types of abdominal trauma

Blunt trauma
Penetrating trauma

3

Name the 3 commonest abdominal injuries due to blunt trauma

Spleen injuries (45%)
Liver injuries (40%)
Retroperitoneal haematoma (15%)

4

What are the consequences of blunt trauma?

Compression or crushing ➔ organ rupture
Deceleration injury ➔ tearing from vascular supply e.g. liver tear and vena cava rupture

5

What factors of an RTA increase the likelihood of blunt trauma?

Fatalities
Any casualty being ejected from vehicle
Closing speed >50mph

6

Name 2 causes of blunt trauma to the abdomen

Road traffic accident (RTA)
Fall or impact

7

Name 2 causes of penetrating trauma

Stab wounds
Gunshot wounds

8

Name the 3 commonest abdominal injuries due to penetrating trauma from stab wounds

Laceration of:
Liver (40%)
Small bowel (30%)
Diaphragm (20%)
Colon (15%)

9

Name the 3 commonest abdominal injuries due to penetrating trauma from high velocity gunshot wounds

Laceration, cavitation, tumble, and fragmentation of:
Small bowel (50%)
Colon (40%)
Liver (30%)
Vessels (25%)

10

Following abdominal trauma, what would be suggestive of intra-abdominal bleeding?

Patient is persistently hypotensive despite resuscitation, and no obvious cause of blood loss identified.

11

What is indicated following abdominal trauma if the patient is stable?

Emergency abdominal CT

12

What is indicated following abdominal trauma if the patient remains critically unstable?

Emergency laparotomy typically

13

Which routine investigations should be done in a presentation of abdominal trauma?

Routine bloods
Urinalysis
Serum amylase ➔ small bowel or pancreatic injury
Erect CXR ➔ perforation

14

What is FAST imaging in abdominal injury?

Focused abdominal sonography for trauma.

Imaging of 4 Ps: Morrison's pouch (hepatorenal recess), Pouch of Douglas (rectouterine pouch), Perisplenic, and Pericardium.

To detect peritoneal and pericardial haemorrhage.

15

What is the role of abdominal CT in abdominal trauma?

Investigation of choice in haemodynamically stable patients with no indication of emergency laparotomy.

Provides detailed information relative to specific organ injury and its extent ➔ may guide management

16

What are the indications for urgent laparotomy in abdominal trauma?

Blunt abdominal trauma with CT features of solid organ injury, not suitable for conservative management.
Peritonitis
Knife injury associated with visible viscera, haemodynamic instability, sepsis
Any gunshot wound

17

What is the indication for resuscitative laparotomy in abdominal trauma?

Blunt abdominal trauma with unresponsive hypotension despite adequate fluid resus, and no other identified cause of bleeding.