Clinical & Experimental Cardiology
Open Access

Abdominal Trauma

Abdominal trauma is an injury to the abdomen. Signs and symptoms include abdominal pain, tenderness, rigidity, and bruising of the external abdomen. Complications may include blood loss and infection. Diagnosis may involve ultrasonography, computed tomography, and peritoneal lavage, and treatment may involve surgery. It is divided into two types blunt or penetrating and may involve damage to the abdominal organs. Injury to the lower chest may cause splenic or liver injuries.

Signs and symptoms are not seen in early days and after some days initial pain is seen. People injured in motor vehicle collisions may present with a "seat belt sign", bruising on the abdomen along the site of the lap portion of the safety belt; this sign is associated with a high rate of injury to the abdominal organs. Seatbelts may also cause abrasions and hematomas; up to 30 percent of people with such signs have associated internal injuries.

Early indications of abdominal trauma include nausea, vomiting, blood in the urine, and fever. The injury may present with abdominal pain, tenderness, distension, or rigidity to the touch, and bowel sounds may be diminished or absent. Abdominal guarding is a tensing of the abdominal wall muscles to guard inflamed organs within the abdomen. Pneumoperitoneum, air or gas in the abdominal cavity, may be an indication of rupture of a hollow organ. In penetrating injuries, an evisceration (protrusion of internal organs out of a wound) may be present.

Initial treatment involves stabilizing the patient enough to ensure adequate airway, breathing, and circulation, and identifying other injuries. Surgery may be needed to repair injured organs. Surgical exploration is necessary for people with penetrating injuries and signs of peritonitis or shock. Laparotomy is often performed in blunt abdominal trauma, and is urgently required if an abdominal injury causes a large, potentially deadly bleed. The main goal is to stop any sources of bleeding before moving onto any definitive find and repair any injuries that are found.Due to the time sensitive nature, this procedure also emphasizes expedience in terms of gaining access and controlling the bleeding, thus favoring a long midline incession. Intra-abdominal injuries are also frequently successfully treated nonoperatively as there is little benefit shown if there is no known active bleeding or potential for infection.