The results are illustrated by an analysis of 1,500 cases of abdominal trauma, 1,314 highvelocity gunshot wounds, 29 stab wounds, 157 blunt injuries. Report the epidemiology and abdominal trauma experience in a private hospital at mexico city from september 2010 to september 2011. Abdominal trauma can be lifethreatening because abdominal organs, especially those in the retroperitoneal space, can bleed profusely, and the space can hold a great deal of blood. Abdominal trauma may involve penetrating or blunt injuries. Pediatric trauma guidelines page pediatric head trauma ct decision 2 cervical spine clearance in children after trauma 34. Trauma abdominal cerrado y penetrante con lesion a. Trauma is the second largest cause of disease accounting for 16% of global burden. Abuzidan9, massimo sartelli10, george velmahos11, gustavo pereira fraga8, ari. Nem todo trauma do abdome, seja ele penetrante ou fechado, leva a lesoes internas. Abdominal trauma is classified as blunt or penetrating, assessment and management is modified accordingly. Penetrating injuries often result in injury to hollow organs, such as the intestines. Equivocal abdominal exam ongoing blood loss hematuria prolonged operation for other injuries immediate operation peritonitis on exam hypotension with. Further research is needed to determine the role of focused abdominal sonography for trauma scanning in diagnostic protocols.
Abdominal trauma accounts for 22% of body regions injured in major trauma and can be difficult to diagnose and manage 2. Epidemiologia del trauma en mexico digestive surgery blog. Manejo conservador del trauma abdominal criterio clasico. Abdominal penetrating trauma an overview sciencedirect.
There are a wide variety of complex structures in each of these areas each with their own unique problems when injured. Dpl or ultrasound evisceration open pelvic fracture anterior stab wound 4 gunshot wound ultrasound or ct ultrasound or dpl 2. Main symptoms include abdominal pain, tenderness, and bruising of the external abdomen. Screening diagnostic peritoneal lavage and selective ct is a safe diagnostic strategy for the investigation of blunt abdominal trauma. Blunt abdominal trauma bat is a frequent emergency and is associated with significant morbidity and mortality in spite of improved recognition, diagnosis and management. Penetrating injuries include gunshot and shrapnel injuries, impalements, and knifings. The nature and severity of abdominal injuries vary widely depending on the mechanism and forces involved, thus generalizations about mortality and need for operative repair tend to be misleading. Abdominal trauma is responsible for about 10% of all deaths related to trama. Perspectives on the management of abdominal trauma abstract the main consequences of abdominal trauma are haemorrhage and sepsis. Review open access the open abdomen in trauma and non trauma patients. Abdominal trauma society for academic emergency medicine. In mexico, abdominal trauma represents an important cause of morbidity and mortality, especially in young patients. It also can cause a risk of severe blood loss and infection.
Blunt abdominal trauma 60 blunt splenic trauma 6162 blunt bowel and mesenteric injury 6364 rectal injury 65 pelvic fracture 6667. Abdominal trauma is an injury that occurs in abdomen of a person. A high index of suspicion should be maintained for any multi trauma patient, particularly where the mechanism of injury may suggest significant abdominal injury. Common causes of abdominal injury include blunt trauma motor vehicle accidents mvas and falls, and penetrating trauma gunshot wounds gsws and stabbings. Maria del carmen dubon peniche a, maria eugenia romero vilchis b. Shoulder tip pain kehrs sign significant abdominal injuries may present with little external evidence of trauma or a trivial pattern of injury and or mechanism. It may be blunt or penetrating and may involve damage to the abdominal organs.
Abdominal trauma is seen quite often in the emergency department and can result from blunt or penetrating mechanisms. Abdominal injuriesepidemiology intermediate care facilities humans. The ati was based on 1 the individual organ severity and 2 the relative risk of early morbidity and mortality estimated for each organ. Cullens sign, grey turner sign and distension can be a late sign and difficult to determine. Blunt abdominal trauma bat is frequently encountered in the form of motor vehicle crashes mvcs 75%, followed by falls and direct abdominal impact. Early deaths following abdominal trauma are usually attributable to haemorrhage. The nature and severity of abdominal injuries vary widely depending on the mechanism and forces involved, thus generalizations about mortality and need for. The timely recognition and appropriate surgical management of abdominal trauma is an essential lifesaving skill that can dramatically impact on outcomes. Common abdominal organ injuries involve the liver, spleen, kidneys, intestines and vasculature. An observational, descriptive, retrospective and longitudinal study. Ppt abdominal trauma powerpoint presentation free to. The blunt abdominal trauma, responsible for most abdominal injuries resulting from trauma, can manifest clinically in many ways.
When evaluating a patient for abdominal trauma, it is necessary to think of the abdomen as three separate areas, which consist of the peritoneal cavity, pelvis, and the retro peritoneum. Also, failure to diagnose abdominal wall trauma can result in misdiagnosis or delayed complications, which may necessitate a more complicated repair 57. In the radiologic evaluation of abdominal pain after nonpenetrating trauma, additional diagnostic considerations include inguinal disruption. Abdominal injuries are found in 2030% of patients with multiorgan injuries. Sepsis is the most common cause in deaths occurring more than 48 hours after injury. The management depends on the clinical status of the patient. The penetrating abdominal trauma index pati was developed in 1979 6 as a result of the inadequacies of iss to assist in clinical investigation of penetrating wounds, and was subsequently modified to the abdominal trauma index ati 7. Patients with open or penetrating abdominal trauma are usually subjected to exploratory laparotomy, however, in selected cases, many surgeons decide not to operate and keep their patients under observation since this expectant. Pereira8, giulia montori1, marco ceresoli1, fikri m. The abdomen can be injured in many types of trauma. Solid abdominal organs, such as the liver and kidneys, bleed profusely when cut or torn, as do major blood vessels such as the aorta and vena cava. Common mechanisms include road traffic crashes, falls, sports injuries and assaults.
Caracteristicas epidemiologicas del trauma abdominal en. Blunt abdominal injuries often managed conservatively, though interventional radiology and surgery are indicated for severe injuries. Abdominal traumaomics internationaljournal of trauma and. Debido al tamano aumentado del tronco del nino en relacion con sus extremidades las lesiones abdominales son extremadamente frecuentes. Serie monografica manejo inicial del politraumatismo. Wses guidelines federico coccolini1, derek roberts2, luca ansaloni1, rao ivatury3, emiliano gamberini4, yoram kluger5, ernest e.