surgical procedures and management

Apr 15th, 2015
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ABDOMINAL INJURYANATOMYAbdomen is divided into 4 areas intrathoracic abdomen pelvic abdomen retroperitoneal abdomen true abdomenEtiology Blunt abdominal injuryRoad traffic accidentsSeat belt injuriesFalls from heightAssault with blunt objectSports injuries Penetrating abdominal injury Stab wounds Gun shot woundsPathophysiology(blunt) Deceleration Causing hollow, solid, visceral organs and vascularpedicles to tear Crushing between the anterior abdominal wall and the vertebralcolumn or posterior thoracic cage External compressive forces resulting in a sudden and dramatic rise in intraabdominal pressurePathophysiology(penetrating)Gun shot injuries High-energy transfer with an unpredictable pattern of injuries Injury is through fragmentation, cavitation, heat and directtrauma Injury severity depends on distance travelled and velocity ofbullet Commonly injured structuresSmall bowel (50%)Colon (40%)Liver (30%)Abdominal vascular structures (25%)Pathophysiology(penetrating)Stab wounds Caused by penetration of the abdominal wall by a sharpobject. Can be accidental or homicidal More predictable pattern of organ injury Most commonly injured organs areLiver (40%)Small bowel (30%)Diaphragm (20%)Colon (15%)Diagnosis History is important but not at the expense of life threateninginjuries The major cause

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