Lecture notes
abdominal trauma
- Module
- General Surgery 2
- Institution
- Cambridge University (CAM)
Lecture notes of 15 pages for the course General Surgery 2 at CAM (.)
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Abdominal TraumaIntroduction
•Abdominal trauma = an injury to the abdomen.
•Abdominal injuries occur either as a result of blunt injuries, penetrating injuries or
both.
•The common causes are road traffic accidents, falls from heights, blows to the
abdomen, blast injuries, and abdominal compression and gunshot and stab wounds.
•The majority of blunt abdominal trauma is due to motor vehicle accidents.
•The increased use in recent years of car safety features such as seat belts and air bags
has lead to a significant reduction in the incidence of these injuries.
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, Penetrating Abdominal Trauma
•Penetrating injuries are caused by a variety of gunshot wounds and a wide array of
stabbing injuries.
•In every penetrating abdominal injury, a surgical consultation is mandatory.
•It is important to remember that a high abdominal wound may have entered the
thoracic cavity.
•Conversely, a penetrating injury to the chest, inferior to the nipples anteriorly or to the
tip of the scapula posteriorly, is quite likely to cause an intra-abdominal injury
•If the patient is in shock after penetrating abdominal wounds, one must suspect a
major vascular injury (aorta, vena cava) or serious solid organ hemorrhage.
•In these cases, immediate surgery is mandatory
Gunshot Wounds
•Gunshot wounds may travel through the body in many directions, and may involve
multiple noncontiguous organs.
•When evaluating the degree of injury one must always consider:
–time of injury
–type of weapon used (including shooting velocity)
–number of shots taken
–amount of blood present at the scene
•When evaluating the degree of injury, consider:
–time of injury: If the patient is unstable and there is a short time interval between the
time of injury and assessment, the injury should be considered serious.
– Type of weapon used: A close-up shooting with a shotgun is more serious than with
a handgun. Automatic rifle fire with a machine gun is more serious still.
–number of shots taken: Multiple shots with a handgun, machine gun or shotgun has a
poorer outlook for the patient.
–amount of blood at the scene: This is often difficult to assess but obviously, the
more blood loss the more serious the injuries.
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