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Acute Abdominal Trauma: Types, Diagnosis & Treatment

Instructor: Dan Washmuth

Dan has taught college Nutrition, Anatomy, Physiology, and Sports Nutrition courses and has a master's degree in Dietetics & Nutrition.

Acute abdominal trauma can involve very serious, potentially life-threatening injuries. Find out about the types, symptoms, diagnosis, and treatments for acute abdominal trauma.

Stomach Problems

Oliver is a 43-year-old who was just brought to the ER. He was involved in a car crash in which his steering wheel slammed into his chest and stomach. When he arrived in the ER, Oliver was suffering from severe stomach pains, difficulty breathing, and had the early signs of shock, including cold skin, a rapid and faint pulse, and confusion.

If you were a nurse in the ER, would you know what to do with Oliver?

Acute Abdominal Trauma

The word 'trauma' involves a physical injury to the body. Therefore, acute abdominal trauma involves injury to the abdomen. The term 'acute trauma' refers to injures that have a very fast onset, such as injuries sustained in a car accident. Non-acute injuries are injuries that occur slowly over time, such as heart disease or pressure ulcers. There are two main types of acute abdominal trauma: blunt force trauma and penetrating trauma.

Blunt Force Trauma

Blunt force trauma occurs when a strong force hits the body (in this case, the abdomen), but does not penetrate the skin. This force can be an object such as a baseball bat, kick, steering wheel during a car accident (like with Oliver), or even a person falling off their roof and landing on their stomach.

The liver and spleen are the most commonly injured organs from blunt force trauma, followed by the small and large intestines. Injuries to organs caused by blunt force trauma can result in a hematoma , which is a collection of blood outside of the blood vessels at the location of an injury. It's commonly referred to as a bruise. However, severe blunt force trauma can actually cause the affected organs to rupture and bleed.

The liver and spleen are the most commonly injured abdominal organs with blunt force trauma.
organs

Penetrating Trauma

Penetrating trauma occurs when an object, such as a knife, bullet, stick, or piece of glass, cuts into the abdomen. Since penetrating trauma involves an object cutting into the body, it can result in life-threatening bleeding both internally and externally.

Diagnosis

Oftentimes, injuries caused by acute abdominal trauma cannot be seen with the naked eye, especially for injuries caused by blunt force trauma. For example, if Oliver had severely bruised his liver, a doctor would have a hard time diagnosing this injury by just looking at him. Therefore, internal imaging techniques such as ultrasounds and CT scans are used to help diagnose these types of injuries. Ultrasounds and CT scans will help doctors see any internal tissue damage, bleeding, or other types of injuries that cannot be seen with the naked eye.

CT scans are often used to help diagnose internal injuries caused by acute abdominal trauma.
CT scan

On the other hand, penetrating wounds are much easier to see with the naked eye. After all, it really isn't that difficult to look at someone who got shot in the stomach and know that they have suffered tissue damage to the skin and some internal organs. However, the full extent of damage done by penetrating trauma is much more difficult to diagnose. Therefore, an exploratory laparotomy is often used with these types of injuries. An exploratory laparotomy involves cutting into the abdomen to directly examine the internal organs for any damage or injury.

Treatment

Treatment for severe injuries to the abdominal organs may require surgical repair. During surgery, doctors will often make a vertical incision in the abdomen to open the abdominal cavity. Once the abdominal cavity is opened, doctors are able to directly repair any damage sustained to specific organs.

The loss of too much blood (both internally and externally) can lead to hypovolemic shock. Hypovolemic shock occurs when the body loses more than 20% of its blood supply and can result in the heart not being able to supply the body with enough blood and oxygen. Patients who have sustained large losses of blood may require fluid resuscitation. Fluid resuscitation involves administering fluids directly into the blood stream through an IV. These fluids will help restore blood volume, therefore preventing hypovolemic shock.

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