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9 Cards in this Set
- Front
- Back
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Patho
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Blunt - MVC
Penetrating - stab - check out the lower chest, pelvis, flank and back |
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Hemoperitoneum
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some develop tenderness early
others may remian asymp for hours or days |
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Clinical Features
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solid organ inj - sxs signs due to blood loss
hollow visceral injuries - blood loss and pertoneal contamination retroperitonal injuires - subtle or absent initiatally, duodenal rupture contained particularly in blunt trauma Diaphragmatic injureis - uncommon, diff to dx. |
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Who needs eval?
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Presence of abdominal pain, tenderness, or distention
Mechanism of injury and prehospltal information Lower chest or pelvic injury High-speed collisions Substantial deformity to the vehicle Patient unrestrained MVC with fatalities Unprotected injury (I.e., motorcycle crashes) Inability to tolerate a delayed diagnosis Elderly Significant comorbid diseases Presence of distracting injuries (e,g., long bone fractures) Decreased level of consciousness/altered sensorium Presence of pain-masking drugs or medications |
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PE
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abrasion, contusion
check out the flank, bakc, lower chest, and ant abdomen do mulitple exams pt must be awake, alert, and reliable. |
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DX
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US - fast
CT - gold standard Peritoneal lavage - dont do this anymore. |
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Gun shot
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all requre surgery
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laparotomy
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Gold standard for intraabd inj
-its defintibe, doesnt miss, allow for complete eval of abd and retro All pts with hypotension, abd wall disruption, or peritonitis need surgical exploration. |
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Nonop magamg
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Hepatic - stable
Splenic - MC |
