Blunt And Penetrating Abdominal Injuries

Blunt and penetrating abdominal injuries may damage major blood vessels and internal organs. Such injuries are potentially fatal; the prognosis depends on the extent of injury and the organs damaged but is improved by prompt diagnosis and surgical repair.

Causes

Blunt (non penetrating) abdominal injuries usually result from motor vehicle crashes, fights, falls from heights, and sports accidents. Penetrating abdominal injuries usually result from stabbings and gunshots.

Symptoms

• history of the incident
• pale, cool, clammy skin
• may be evidence of wound
• rapid, weak pulse, with evidence of shock
• rapid, shallow breathing
• abdominal rigidity
• 'guarding' of abdomen - foetal position if lying down
• may be incontinent

Diagnostic tests

Specific tests vary with the patient's condition but usually include abdominal X-rays and examination of the stools and stomach contents for blood. Chest X-rays, preferably done with the patient upright, may show free air from suspect ruptured organs.

Treatment

The patient needs an immediate infusion of I.V. fluids and blood components to control hemorrhage and prevent hypovolemic shock.

The patient also may require intubation and mechanical ventilation or supplemental oxygen, as well as insertion of a nasogastric (NG) tube and an indwelling urinary catheter.

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