The document provides information on abdominal injuries, including:
1) Abdominal injury accounts for a large percentage of trauma injuries and can damage both hollow and solid organs.
2) The abdomen contains many organs and structures that can be injured through blunt or penetrating trauma.
3) Abdominal injuries require careful history, physical exam, and imaging/testing to diagnose and develop a collaborative management plan.
This document discusses intestinal obstruction, including its definition, classification, causes, examination, investigation, pseudo-obstruction, management, and surgical indications. Intestinal obstruction occurs when the contents of the intestine are blocked from passing through. It can be caused by mechanical, paralytic, or functional factors. Examination involves inspection, palpation, percussion, and auscultation of the abdomen. Investigations include blood tests, radiological imaging like abdominal x-rays and CT scans. Pseudo-obstruction is obstruction without a mechanical cause. Management focuses on resuscitation, decompression, fluid replacement, and surgery if signs of strangulation or perforation are present.
Content will be helpful for B.Sc. and M.Sc. nursing students as it describes causes, signs and symptoms, diagnosis,emergency mangement , medical and nursing management.
This document discusses various causes and types of intestinal obstruction, including their presentation, diagnosis and management. It covers mechanical obstructions caused by adhesions, hernias, volvulus and intussusception. It also discusses paralytic ileus and pseudo-obstruction which are adynamic obstructions without a mechanical cause. The management involves supportive care, surgical correction of the underlying cause, and resection of non-viable intestine. Early diagnosis and treatment are important to prevent complications like strangulation.
Gastrointestinal perforation can be caused by a variety of illnesses and medical conditions that damage the intestinal wall such as appendicitis, diverticulitis, ulcers, gallstones, inflammatory bowel diseases, abdominal trauma, surgery, and foreign object ingestion. Symptoms include severe abdominal pain, fever, nausea, vomiting, and rectal bleeding. Diagnosis involves x-rays, CT scans, and lab tests. Treatment is usually surgery to repair the perforation and address underlying causes, though sometimes antibiotics alone may be used if the perforation has closed. Complications can include bleeding, infection, abscesses, and permanent colostomies. Prognosis depends on early diagnosis and treatment as well as individual risk factors
Acute abdomen is an abdominal emergency that requires prompt evaluation and treatment. Patients often present in the evening with sudden onset abdominal pain within the last 24 hours. A thorough history and physical exam are important to determine the cause, which can include appendicitis, cholecystitis, pancreatitis, diverticulitis, perforated ulcer, bowel obstruction, mesenteric ischemia, or ruptured abdominal aortic aneurysm. Diagnostic testing may include bloodwork, imaging studies like ultrasound or CT scan, and surgery if indicated by the condition. Proper diagnosis and management are needed to prevent complications.
This document discusses the management of abdominal trauma. It begins with classifications for abdominal injuries and describes the pathophysiology of blunt and penetrating trauma. The primary and secondary surveys are outlined, including important physical exam findings. Diagnostic imaging options are presented, such as FAST ultrasound, CT scans, and DPL. Specific injuries to organs like the spleen are discussed. Management approaches for both blunt and penetrating trauma are covered, including options for non-operative management versus laparotomy. Damage control resuscitation principles and abdominal compartment syndrome are also mentioned.
This document discusses intestinal obstruction, including its definition, classification, causes, examination, investigation, pseudo-obstruction, management, and surgical indications. Intestinal obstruction occurs when the contents of the intestine are blocked from passing through. It can be caused by mechanical, paralytic, or functional factors. Examination involves inspection, palpation, percussion, and auscultation of the abdomen. Investigations include blood tests, radiological imaging like abdominal x-rays and CT scans. Pseudo-obstruction is obstruction without a mechanical cause. Management focuses on resuscitation, decompression, fluid replacement, and surgery if signs of strangulation or perforation are present.
Content will be helpful for B.Sc. and M.Sc. nursing students as it describes causes, signs and symptoms, diagnosis,emergency mangement , medical and nursing management.
This document discusses various causes and types of intestinal obstruction, including their presentation, diagnosis and management. It covers mechanical obstructions caused by adhesions, hernias, volvulus and intussusception. It also discusses paralytic ileus and pseudo-obstruction which are adynamic obstructions without a mechanical cause. The management involves supportive care, surgical correction of the underlying cause, and resection of non-viable intestine. Early diagnosis and treatment are important to prevent complications like strangulation.
Gastrointestinal perforation can be caused by a variety of illnesses and medical conditions that damage the intestinal wall such as appendicitis, diverticulitis, ulcers, gallstones, inflammatory bowel diseases, abdominal trauma, surgery, and foreign object ingestion. Symptoms include severe abdominal pain, fever, nausea, vomiting, and rectal bleeding. Diagnosis involves x-rays, CT scans, and lab tests. Treatment is usually surgery to repair the perforation and address underlying causes, though sometimes antibiotics alone may be used if the perforation has closed. Complications can include bleeding, infection, abscesses, and permanent colostomies. Prognosis depends on early diagnosis and treatment as well as individual risk factors
Acute abdomen is an abdominal emergency that requires prompt evaluation and treatment. Patients often present in the evening with sudden onset abdominal pain within the last 24 hours. A thorough history and physical exam are important to determine the cause, which can include appendicitis, cholecystitis, pancreatitis, diverticulitis, perforated ulcer, bowel obstruction, mesenteric ischemia, or ruptured abdominal aortic aneurysm. Diagnostic testing may include bloodwork, imaging studies like ultrasound or CT scan, and surgery if indicated by the condition. Proper diagnosis and management are needed to prevent complications.
This document discusses the management of abdominal trauma. It begins with classifications for abdominal injuries and describes the pathophysiology of blunt and penetrating trauma. The primary and secondary surveys are outlined, including important physical exam findings. Diagnostic imaging options are presented, such as FAST ultrasound, CT scans, and DPL. Specific injuries to organs like the spleen are discussed. Management approaches for both blunt and penetrating trauma are covered, including options for non-operative management versus laparotomy. Damage control resuscitation principles and abdominal compartment syndrome are also mentioned.
Intestinal obstruction occurs when the intestine is blocked, preventing normal movement of its contents. It can be caused by mechanical blockages such as tumors or hernias, or functional issues like neuromuscular problems. Symptoms include abdominal pain, vomiting, distension and constipation. Treatment involves fluid resuscitation, antibiotics, pain management, and sometimes surgery to remove the obstruction. Proper diagnosis and timely treatment are important to prevent complications like perforation and sepsis.
Intestinal obstruction occurs when the normal passage of intestinal contents is blocked. It can involve the small intestine, large intestine, or both. Obstructions are classified as mechanical, which involve a physical blockage, or dynamic/adynamic, which involve ineffective motility without a blockage. Common causes include adhesions, hernias, tumors, and volvulus. Symptoms vary based on the location and severity of the obstruction but often include colicky abdominal pain, vomiting, distention, and constipation. Diagnosis involves physical exam findings like distention and hyperperistalsis as well as imaging tests showing gas/fluid levels and other signs of obstruction.
The document discusses complications of peptic ulcers, including perforation, hemorrhage, gastric outlet obstruction, penetration, and malignant change. Perforation is a common complication that occurs when a weak spot in the stomach or duodenal wall ruptures. Symptoms include severe abdominal pain. Treatment involves surgery to repair the perforation along with antibiotics and resuscitation. Bleeding is another major complication that can range from mild to life-threatening. Symptoms include vomiting blood or black stools. Treatment involves endoscopic methods to stop bleeding along with fluid replacement and medications. Surgery may be needed if bleeding cannot be controlled otherwise or for other complications like perforation.
1) Abdominal trauma can result from blunt or penetrating injuries and requires prompt evaluation and treatment to save lives.
2) Clinical signs of abdominal trauma include abdominal pain, distension, discoloration, and shock. Specific signs indicate injuries to organs like the liver or spleen.
3) Evaluation involves visual examination, palpation of the abdomen, and consideration of internal injuries to organs. Imaging like CT scans or ultrasound can help diagnose injuries.
4) Initial management consists of stabilizing the patient, controlling bleeding, giving IV fluids and oxygen, dressing wounds, and monitoring for signs of internal bleeding or injury before determining if surgery is needed.
this presentation includes anatomy physiology function of peritoneum ,also includes cause of peritonitis its severity ,various scoring system investigation and treatment.It includes the recent advancement and latest articles from latest books of surgery.
Gallstones form when certain substances harden in the gallbladder or bile ducts. Risk factors include family history, being a woman over 40, obesity, high-fat diet, and certain medical conditions. Gallstones can cause inflammation of the gallbladder, blockage of ducts, pancreatitis, and rarely cancer. Diagnosis involves ultrasound, blood tests, and endoscopy. Treatment is usually surgical removal of the gallbladder to prevent complications from gallstones.
This document summarizes evaluation and management of blunt abdominal trauma. It defines the abdominal anatomy, describes common injury patterns from compression or deceleration mechanisms. The assessment involves history of the traumatic mechanism and physical exam findings. Diagnostic tools discussed include peritoneal lavage, FAST ultrasound, and CT scan. Algorithms are provided for management of hemodynamically unstable versus stable patients based on EAST guidelines.
The document discusses liver anatomy, injuries, and management approaches. It provides details on:
1) The surface anatomy and blood supply of the liver.
2) Common causes and presentations of liver injuries including blunt trauma, penetrating trauma, and associated injuries.
3) Classification systems for grading liver injuries based on CT imaging findings.
4) Treatment approaches including non-operative management with observation for lower grade injuries or angioembolization for bleeding, and operative management using packing, Pringle maneuver, and resection for higher grade or unstable injuries.
This document discusses disorders of the stomach, including anatomy, physiology, dyspepsia, and peptic ulcer disease (PUD). It covers the anatomy and layers of the stomach, as well as its functions like storage, digestion, and secretion. Gastric secretion and the phases of secretion are described. Dyspepsia is defined and its etiology, differential diagnosis, and approaches to evaluation and management are outlined. PUD and its causes like Helicobacter pylori infection and NSAID use are also summarized. Key signs and symptoms of duodenal and gastric ulcers are provided.
This document discusses intestinal obstruction, including its causes, signs and symptoms, assessments, nursing diagnoses, and treatment. Intestinal obstruction can be mechanical or functional and causes a blockage in the small or large intestine. Common signs are abdominal pain, nausea, vomiting, and constipation. Assessments include physical exams, imaging, and labs. Nursing focuses on relieving pain, maintaining fluid and electrolytes, and preparing for possible surgery. Treatment involves correcting the underlying cause through medical or surgical management.
Seminar presentation by 5th-year medical students under the supervision of in house lecturer. He was previously working as a consultant surgeon in Syria. Reference as mentioned in the slides.
This document discusses the evaluation and management of abdominal injuries. It notes that abdominal injuries occur in 13% of trauma patients and are associated with a 7.7% mortality rate. Blunt trauma can cause organ lacerations and bleeding while penetrating trauma risks organ perforation. Clinical examination is important to assess for peritonitis and hemodynamic instability which indicate need for exploration. Focused abdominal sonography for trauma (FAST) can identify fluid but CT is preferred for stable patients. Diagnostic laparoscopy and laparotomy may be needed but have limitations in fully evaluating injuries.
The document provides guidance on the assessment and management of trauma patients. It describes the golden hour period following trauma where rapid assessment is critical. The primary and secondary surveys are outlined, with the primary focusing on stabilizing vital functions like airway, breathing, circulation, disability and exposure. Specific injuries and treatments are discussed for areas like head trauma, spinal trauma, chest trauma, abdominal trauma and genitourinary trauma. Throughout, the emphasis is on stabilizing life-threatening injuries and rapidly diagnosing and treating problems that could impair ventilation or circulation.
The document defines an acute abdomen as a rapid onset of severe abdominal symptoms that may indicate a life-threatening condition. It lists many potential causes including appendicitis, cholecystitis, pancreatitis, and others. It describes assessing patients with an acute abdomen through history, examination, and potential emergency department care and investigations like blood tests, imaging, and laparoscopy. It highlights some red flags to watch for and includes three case studies.
This document provides information on gastrointestinal bleeding, including its anatomy, definition, epidemiology, clinical features, etiology, history and examination, investigation, and management. It discusses the major sites of upper and lower GI bleeding. For upper GI bleeding it covers topics such as esophageal varices, Mallory-Weiss tears, esophageal cancer, peptic ulcer disease, erosive gastritis, gastric cancer, and Dieulafoy's disease. For lower GI bleeding it briefly mentions duodenitis. It provides details on the pathogenesis, clinical presentation, investigations and treatment of many of these conditions.
Small intestine perforation- Easy ppt for student nurses
definition
causes
clinical manifestations
diagnostic tests
management of small intestine perforation
Intestinal obstruction occurs when there is an interruption of the normal passage of intestinal contents. It can be classified as mechanical or non-mechanical. Common causes of mechanical small bowel obstruction include adhesions, hernias, intussusceptions, and neoplasms. Common causes of mechanical large bowel obstruction are colon cancer, diverticular disease, and sigmoid volvulus. Diagnosis involves determining if obstruction is present and where, assessing for strangulation, and identifying the cause. Treatment depends on whether the obstruction is simple or there are signs of strangulation, and may involve decompression, IV fluids, or surgery.
This document discusses colostomy care and procedures. It defines a colostomy as an artificial opening in the large intestine brought to the surface of the abdomen. It then classifies colostomies as either temporary or permanent, and by stoma site or number/type. Common indications for a colostomy include colon cancer, Hirschsprung's disease, and ulcerative colitis. The purpose of colostomy care is to protect the skin, provide drainage, clean and regulate the bowel, and enable patient self-care. Required equipment includes supplies for changing appliances and bags, as well as accessories like filters, tape, soap, and gloves. Colostomy irrigation is defined as introducing a solution through the
1) Abdominal trauma is commonly encountered in the emergency department and can be challenging to diagnose due to subtle or delayed presentations of serious intra-abdominal injuries.
2) A thorough primary and secondary survey including vital signs monitoring, focused assessment with ultrasound, and diagnostic tests like CT scan are used to identify injuries.
3) Uncontrolled hemorrhage and sepsis are major causes of mortality, so prompt diagnosis and management of injuries is important to prevent complications.
This document provides an overview of abdominal trauma, including anatomy, injury mechanisms, signs and symptoms, and management. It discusses injuries to solid organs like the liver and spleen which can cause heavy bleeding and shock. It also addresses injuries to hollow organs such as the stomach and intestines which can lead to inflammation from spilled contents. The document stresses the importance of promptly evaluating and resuscitating patients with abdominal trauma to prevent death from delayed treatment or diagnosis.
Intestinal obstruction occurs when the intestine is blocked, preventing normal movement of its contents. It can be caused by mechanical blockages such as tumors or hernias, or functional issues like neuromuscular problems. Symptoms include abdominal pain, vomiting, distension and constipation. Treatment involves fluid resuscitation, antibiotics, pain management, and sometimes surgery to remove the obstruction. Proper diagnosis and timely treatment are important to prevent complications like perforation and sepsis.
Intestinal obstruction occurs when the normal passage of intestinal contents is blocked. It can involve the small intestine, large intestine, or both. Obstructions are classified as mechanical, which involve a physical blockage, or dynamic/adynamic, which involve ineffective motility without a blockage. Common causes include adhesions, hernias, tumors, and volvulus. Symptoms vary based on the location and severity of the obstruction but often include colicky abdominal pain, vomiting, distention, and constipation. Diagnosis involves physical exam findings like distention and hyperperistalsis as well as imaging tests showing gas/fluid levels and other signs of obstruction.
The document discusses complications of peptic ulcers, including perforation, hemorrhage, gastric outlet obstruction, penetration, and malignant change. Perforation is a common complication that occurs when a weak spot in the stomach or duodenal wall ruptures. Symptoms include severe abdominal pain. Treatment involves surgery to repair the perforation along with antibiotics and resuscitation. Bleeding is another major complication that can range from mild to life-threatening. Symptoms include vomiting blood or black stools. Treatment involves endoscopic methods to stop bleeding along with fluid replacement and medications. Surgery may be needed if bleeding cannot be controlled otherwise or for other complications like perforation.
1) Abdominal trauma can result from blunt or penetrating injuries and requires prompt evaluation and treatment to save lives.
2) Clinical signs of abdominal trauma include abdominal pain, distension, discoloration, and shock. Specific signs indicate injuries to organs like the liver or spleen.
3) Evaluation involves visual examination, palpation of the abdomen, and consideration of internal injuries to organs. Imaging like CT scans or ultrasound can help diagnose injuries.
4) Initial management consists of stabilizing the patient, controlling bleeding, giving IV fluids and oxygen, dressing wounds, and monitoring for signs of internal bleeding or injury before determining if surgery is needed.
this presentation includes anatomy physiology function of peritoneum ,also includes cause of peritonitis its severity ,various scoring system investigation and treatment.It includes the recent advancement and latest articles from latest books of surgery.
Gallstones form when certain substances harden in the gallbladder or bile ducts. Risk factors include family history, being a woman over 40, obesity, high-fat diet, and certain medical conditions. Gallstones can cause inflammation of the gallbladder, blockage of ducts, pancreatitis, and rarely cancer. Diagnosis involves ultrasound, blood tests, and endoscopy. Treatment is usually surgical removal of the gallbladder to prevent complications from gallstones.
This document summarizes evaluation and management of blunt abdominal trauma. It defines the abdominal anatomy, describes common injury patterns from compression or deceleration mechanisms. The assessment involves history of the traumatic mechanism and physical exam findings. Diagnostic tools discussed include peritoneal lavage, FAST ultrasound, and CT scan. Algorithms are provided for management of hemodynamically unstable versus stable patients based on EAST guidelines.
The document discusses liver anatomy, injuries, and management approaches. It provides details on:
1) The surface anatomy and blood supply of the liver.
2) Common causes and presentations of liver injuries including blunt trauma, penetrating trauma, and associated injuries.
3) Classification systems for grading liver injuries based on CT imaging findings.
4) Treatment approaches including non-operative management with observation for lower grade injuries or angioembolization for bleeding, and operative management using packing, Pringle maneuver, and resection for higher grade or unstable injuries.
This document discusses disorders of the stomach, including anatomy, physiology, dyspepsia, and peptic ulcer disease (PUD). It covers the anatomy and layers of the stomach, as well as its functions like storage, digestion, and secretion. Gastric secretion and the phases of secretion are described. Dyspepsia is defined and its etiology, differential diagnosis, and approaches to evaluation and management are outlined. PUD and its causes like Helicobacter pylori infection and NSAID use are also summarized. Key signs and symptoms of duodenal and gastric ulcers are provided.
This document discusses intestinal obstruction, including its causes, signs and symptoms, assessments, nursing diagnoses, and treatment. Intestinal obstruction can be mechanical or functional and causes a blockage in the small or large intestine. Common signs are abdominal pain, nausea, vomiting, and constipation. Assessments include physical exams, imaging, and labs. Nursing focuses on relieving pain, maintaining fluid and electrolytes, and preparing for possible surgery. Treatment involves correcting the underlying cause through medical or surgical management.
Seminar presentation by 5th-year medical students under the supervision of in house lecturer. He was previously working as a consultant surgeon in Syria. Reference as mentioned in the slides.
This document discusses the evaluation and management of abdominal injuries. It notes that abdominal injuries occur in 13% of trauma patients and are associated with a 7.7% mortality rate. Blunt trauma can cause organ lacerations and bleeding while penetrating trauma risks organ perforation. Clinical examination is important to assess for peritonitis and hemodynamic instability which indicate need for exploration. Focused abdominal sonography for trauma (FAST) can identify fluid but CT is preferred for stable patients. Diagnostic laparoscopy and laparotomy may be needed but have limitations in fully evaluating injuries.
The document provides guidance on the assessment and management of trauma patients. It describes the golden hour period following trauma where rapid assessment is critical. The primary and secondary surveys are outlined, with the primary focusing on stabilizing vital functions like airway, breathing, circulation, disability and exposure. Specific injuries and treatments are discussed for areas like head trauma, spinal trauma, chest trauma, abdominal trauma and genitourinary trauma. Throughout, the emphasis is on stabilizing life-threatening injuries and rapidly diagnosing and treating problems that could impair ventilation or circulation.
The document defines an acute abdomen as a rapid onset of severe abdominal symptoms that may indicate a life-threatening condition. It lists many potential causes including appendicitis, cholecystitis, pancreatitis, and others. It describes assessing patients with an acute abdomen through history, examination, and potential emergency department care and investigations like blood tests, imaging, and laparoscopy. It highlights some red flags to watch for and includes three case studies.
This document provides information on gastrointestinal bleeding, including its anatomy, definition, epidemiology, clinical features, etiology, history and examination, investigation, and management. It discusses the major sites of upper and lower GI bleeding. For upper GI bleeding it covers topics such as esophageal varices, Mallory-Weiss tears, esophageal cancer, peptic ulcer disease, erosive gastritis, gastric cancer, and Dieulafoy's disease. For lower GI bleeding it briefly mentions duodenitis. It provides details on the pathogenesis, clinical presentation, investigations and treatment of many of these conditions.
Small intestine perforation- Easy ppt for student nurses
definition
causes
clinical manifestations
diagnostic tests
management of small intestine perforation
Intestinal obstruction occurs when there is an interruption of the normal passage of intestinal contents. It can be classified as mechanical or non-mechanical. Common causes of mechanical small bowel obstruction include adhesions, hernias, intussusceptions, and neoplasms. Common causes of mechanical large bowel obstruction are colon cancer, diverticular disease, and sigmoid volvulus. Diagnosis involves determining if obstruction is present and where, assessing for strangulation, and identifying the cause. Treatment depends on whether the obstruction is simple or there are signs of strangulation, and may involve decompression, IV fluids, or surgery.
This document discusses colostomy care and procedures. It defines a colostomy as an artificial opening in the large intestine brought to the surface of the abdomen. It then classifies colostomies as either temporary or permanent, and by stoma site or number/type. Common indications for a colostomy include colon cancer, Hirschsprung's disease, and ulcerative colitis. The purpose of colostomy care is to protect the skin, provide drainage, clean and regulate the bowel, and enable patient self-care. Required equipment includes supplies for changing appliances and bags, as well as accessories like filters, tape, soap, and gloves. Colostomy irrigation is defined as introducing a solution through the
1) Abdominal trauma is commonly encountered in the emergency department and can be challenging to diagnose due to subtle or delayed presentations of serious intra-abdominal injuries.
2) A thorough primary and secondary survey including vital signs monitoring, focused assessment with ultrasound, and diagnostic tests like CT scan are used to identify injuries.
3) Uncontrolled hemorrhage and sepsis are major causes of mortality, so prompt diagnosis and management of injuries is important to prevent complications.
This document provides an overview of abdominal trauma, including anatomy, injury mechanisms, signs and symptoms, and management. It discusses injuries to solid organs like the liver and spleen which can cause heavy bleeding and shock. It also addresses injuries to hollow organs such as the stomach and intestines which can lead to inflammation from spilled contents. The document stresses the importance of promptly evaluating and resuscitating patients with abdominal trauma to prevent death from delayed treatment or diagnosis.
1) The document discusses the diagnosis and treatment of intra-abdominal injuries, including the external anatomy of the abdomen, classification of injuries as blunt, penetrating, or iatrogenic, signs and symptoms of potential abdominal injury, and priorities for diagnosis and management.
2) Key diagnostic tests discussed are physical exam, plain films, FAST ultrasound, CT scan, diagnostic peritoneal lavage, and exploratory laparotomy. Indications, advantages, limitations, and sensitivities of each test are provided.
3) Treatment priorities and approaches are outlined, including resuscitation, damage control resuscitation, identifying the source of bleeding, and surgical procedures for exploratory laparotomy and repair of specific organ injuries
This document discusses abdominal trauma, including the anatomy of the abdomen, common mechanisms of injury like motor vehicle accidents and penetrating wounds, and the pathophysiology of blunt versus penetrating trauma. The most commonly injured organs from blunt trauma are the spleen, liver, and small bowel due to shearing and compression forces that can tear or rupture these solid organs.
1. Abdominal trauma is commonly encountered in emergency departments and can be life-threatening. Blunt and penetrating injuries can cause damage to solid organs like the spleen, liver, and pancreas.
2. A thorough primary and secondary survey is essential to identify injuries. Diagnostic tools like FAST ultrasound, CT scans, and laparoscopy help evaluate injuries. Conservative management is appropriate for many mild organ injuries.
3. Splenic injuries require close monitoring or surgery depending on grade. Liver injuries often stop bleeding spontaneously but may require packing or resection. Pancreatic injuries are difficult to diagnose and usually repaired surgically. Proper identification and treatment of abdominal injuries is critical for patient outcomes.
This document discusses the classification and mechanisms of tissue injuries. It covers soft tissue injuries, hard tissue injuries, and special tissue injuries. The three phases of the general repair process are described as the acute inflammatory response, matrix and cellular proliferation, and remodeling and maturation. Basic biomechanics of muscle-tendon-bone injuries and the muscle-tendon junction are also outlined. Specific sections cover ligaments and tendons, bone, fibrocartilage menisci, and muscle injuries and healing processes.
The document summarizes key information about the large bowel (large intestine), including its anatomy, functions, signs and symptoms of obstruction, diagnostic evaluation, and management approaches. The large bowel extends from the distal ileum to the anus and includes the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum. It completes the absorption of water, aids in vitamin production by gut flora, and stores and expels feces. Large bowel obstruction presents with abdominal pain, vomiting, constipation, distension, and potential peritonitis. Evaluation includes abdominal x-rays, CT scans, and endoscopy. Initial management focuses on resuscitation, and surgery versus conservative approaches depend on the severity
This document discusses various causes and radiological findings of large bowel obstruction. The most common causes are cancer (60%), diverticulitis (20%), and volvulus (5%). Radiological findings of large bowel obstruction include a peripherally located distended bowel with haustral markings and no air distal to the site of obstruction. Barium enema can demonstrate the level and degree of obstruction, and may show findings like an "inverted U-shaped" sigmoid loop or "bird's beak" sign in sigmoid volvulus. CT scan with oral and IV contrast is also useful to evaluate bowel obstruction and its underlying cause.
This document provides an overview of abdominal trauma. It begins by discussing epidemiology, noting that abdominal trauma is a leading cause of death, especially in those aged 15-30 from motor vehicle accidents and falls. It then covers types of abdominal trauma including blunt and penetrating. Specific injuries like liver, spleen, and hollow viscus injuries are discussed. Diagnostic tools like FAST, CT, and laparoscopy are summarized. Management of unstable versus stable patients is outlined. Finally, it notes that pediatric abdominal trauma is usually blunt and has a high success rate with non-operative management.
This document provides an overview of intestinal obstruction, including its classification, common causes, clinical features, investigations, and treatment options. Intestinal obstruction can result from mechanical blockage from structural abnormalities (dynamic obstruction) or paralysis without physical obstruction (ileus). Common causes of dynamic obstruction include adhesions, hernias, volvulus, and intussusception. Clinical features include colicky pain, vomiting, abdominal distention, and constipation. Investigations may include blood tests, abdominal x-rays, and CT scans. Treatment involves resuscitation, nasogastric decompression, IV fluids, and potentially surgery to resolve the obstruction. Complications can include bleeding, infection, leakage, and reoccurrence of obstruction
The document discusses abdominal trauma, providing information on epidemiology, anatomy, classification, mechanisms of injury, signs and symptoms, diagnosis, and management. It notes that abdominal trauma can be blunt or penetrating, with the most common causes being motor vehicle accidents and assaults. Physical examination may reveal signs of internal bleeding or peritonitis, while imaging tools like ultrasound, CT scans, and diagnostic peritoneal lavage can aid in diagnosis. Resuscitation involves stabilizing the patient and controlling bleeding, while surgical intervention may be needed for injuries to hollow organs or solid organs like the liver or spleen.
This document discusses abdominal trauma, including common causes, mechanisms of injury, signs and symptoms, and types of abdominal injuries. It focuses on injuries to the liver and spleen from blunt trauma. Liver injuries can range from superficial lacerations to severe vascular damage, often causing profuse bleeding. While traditionally treated with surgery, many liver injuries can now be managed non-operatively. Splenic injuries also often result from blunt trauma and may cause referred pain to the left shoulder. Proper assessment of abdominal trauma requires understanding the mechanism of injury and potential concurrent injuries.
The document summarizes abdominal injuries, including:
- The abdomen lacks protective bones, so injuries can seriously damage organs like the liver, spleen, and stomach. Significant bleeding may occur.
- Abdominal injuries are classified based on the damaged structure (e.g. organ, blood vessel) and type (blunt or penetrating). Blunt trauma commonly injures the spleen or liver while penetrating injuries often cause more damage.
- Symptoms may include abdominal pain or tenderness, though pain levels vary. Significant bleeding can cause low blood pressure, fast heart rate, and pale skin. Diagnosis involves imaging tests and monitoring for worsening symptoms. Treatment focuses on replacing lost blood and surgically repairing injuries
1) Abdominal trauma is the third most common type of trauma after head and chest injuries, with 25% of major trauma victims requiring abdominal exploration. Blunt trauma accounts for 75% of abdominal injuries, most often from road traffic accidents.
2) The spleen, liver, and small bowel are the organs most commonly injured in abdominal trauma. Solid organs like the liver and spleen are vulnerable to tearing at sites of ligament attachment from rapid deceleration.
3) Outcomes of abdominal trauma depend on the mechanism of injury. Blunt trauma can cause bruising, bleeding, organ rupture, and delayed complications. Penetrating injuries directly damage organs in the path of the object. Assessment of injury severity is crucial for
The document discusses the anatomy of the abdomen, including the peritoneal cavity, peritoneum, and inguinal canal. It describes the peritoneal cavity as the potential space between the parietal and visceral peritoneum that contains a thin film of peritoneal fluid. Disorders like ascites and peritonitis that affect the peritoneal cavity are also summarized.
1) Bladder trauma can occur from blunt or penetrating injuries and result in extraperitoneal or intraperitoneal ruptures. The most common causes are road traffic accidents, falls, assaults, or surgical complications.
2) Blunt trauma is more likely to cause extraperitoneal ruptures, especially if associated with pelvic fractures. Intraperitoneal ruptures usually result from a direct blow to a distended bladder.
3) Clinical manifestations include gross hematuria, suprapubic pain, and difficulty voiding. CT scans and cystography are used for diagnosis. Most extraperitoneal ruptures can be managed with catheter drainage but intraperitoneal ruptures often require surgical repair.
This document provides an overview of abdominal trauma, including anatomy, injury assessment, management, and specific injuries to solid organs, hollow organs, major blood vessels, and the urinary system. Key points include:
- The abdomen contains many organs that can be difficult to assess when injured.
- Solid organ injuries like the liver, spleen, and kidneys can cause severe bleeding and shock.
- Hollow organ ruptures from the stomach, intestines, and bladder allow stomach/intestinal contents or urine to spill into the abdomen, causing inflammation.
- Failure to properly evaluate, resuscitate, diagnose, or treat abdominal injuries in a timely manner can lead to death.
This document provides an overview of acute abdomen, including definitions, classifications, pathophysiology, assessment, differential diagnosis, and common causes. It defines acute abdomen as sudden, severe abdominal pain, which is a common complaint in emergency departments. Acute abdomen is classified based on systems affected (intra-abdominal, extra-abdominal, nonspecific) and location of pain (quadrants). A thorough history and physical exam are important for assessment, while differential diagnosis is wide-ranging and depends on location and characteristics of the pain. Common differentials discussed include appendicitis, cholecystitis, small bowel obstruction, and perforated ulcer.
Injuries to bowel and mesentery. Lecture pptxShashi Prakash
The document discusses traumatic injuries to the bowel and mesentery from blunt abdominal trauma. It notes that the bowel and mesentery are commonly injured structures after the liver and spleen. Delayed diagnosis of 8 hours or more of bowel and mesenteric injuries can result in severe complications like bleeding, peritonitis, and sepsis. CT scans are important for diagnosis as they can identify signs of intestinal perforation, bleeding, or vascular injuries that require immediate surgery. The most common sites of bowel injury are the small bowel, particularly the proximal jejunum and distal ileum. Colon injuries from blunt trauma are less common.
Certain Gastrointestinal Disorders Can Be Life Threatening And Require Emerge...guestd0d4e1
Certain gastrointestinal disorders like abdominal pain, gastrointestinal bleeding, and abdominal abscesses can require emergency surgery. Doctors must quickly determine if surgery is needed to identify and treat the underlying problem. Abdominal abscesses in particular cause pain and other symptoms depending on their location, and are usually diagnosed using imaging tests before being treated by draining pus and antibiotics. Abdominal hernias, which cause bulging but little pain, are also common and usually repaired through elective surgery to prevent potential incarceration or strangulation of intestine tissue.
Certain Gastrointestinal Disorders Can Be Life Threatening And Require Emerge...Deep Deep
Certain gastrointestinal disorders like abdominal pain, gastrointestinal bleeding, and abdominal abscesses can require emergency surgery. Doctors must quickly determine if surgery is needed to identify and treat the underlying problem. Abdominal abscesses in particular cause pain and other symptoms depending on their location, and are usually diagnosed using imaging tests before being treated by draining pus and antibiotics. Abdominal hernias, which cause bulging but little pain, are also common and usually repaired through elective surgery to prevent potential incarceration or strangulation of intestine tissue.
HI, i am Maitri Doshi, a medical student, showing many different presentations that i made.
It has introduction, causes, signs and symptoms, complications, and diagnosis.
Short and easy to understand about GI obstruction.
This document summarizes various injuries and conditions related to the upper extremities, thorax, abdomen, and reproductive systems. It describes injuries such as pneumothorax, hemothorax, liver and splenic injuries, as well as conditions like kidney stones, appendicitis, pelvic inflammatory disease, and testicular torsion. Signs, symptoms, risk factors, and treatments are outlined for each pathology.
A hernia occurs when an organ or fatty tissue protrudes through a weakness in the muscle or surrounding wall of the cavity it is normally contained within. The document defines hernia and describes the different types including inguinal, femoral, umbilical, incisional, and hiatal hernias. It discusses the causes, symptoms, complications, methods of diagnosis, and treatment options for hernia which include medical management with trusses or surgery to repair the defect.
This presentation covers anatomy of the respiratory system, mechanisms of breathing, classification and types of chest trauma, initial assessment of thoracic injuries, and nursing interventions. Key topics include defining rib fractures, flail chest, pneumothorax, cardiac tamponade, and aortic injury. Assessment and management of these thoracic injuries is discussed as well as nursing priorities like airway maintenance, analgesia, and respiratory support.
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1. PEER GROUP PRESENTATION
ON
ABDOMINAL INJURY
Submitted by-
Sampurna Das
MSc. Nursing 2nd
year
College Of Nursing
Medical College & Hospital
INTRODUCTION:
2. Abdominal injury account for a large percentage of trauma related injuries and death. The visceral
organs contained within the abdomen can be classified as either hollow or solid.
Damage to a hollow organ can result in acute peritonitis leading to shock within a few hours & damage
to solid organs can result in lethal haemorrhage.
The abdomen can be injured in many ways. The abdomen alone may be injured or injuries elsewhere in
the body may also occur. Injuries can be relatively mild or very severe.
ANATOMY & PHYSIOLOGY OF ABDOMEN:
The abdomen constitutes the part of the body between the thorax(chest) and pelvis, in humans and
in other vertebrates.
The region enclosed by the abdomen is termed the abdominal cavity.
The abdomen stretches from the thorax at the thoracic diaphragm to the pelvis at the pelvic brim.
The pelvic brim stretches from the lumbosacral joint (theintervertebral disc between L5 and S1) to
the pubic symphysis and is the edge of the pelvic inlet. The space above this inlet and under the
thoracic diaphragm is termed the abdominal cavity.
The boundary of the abdominal cavity is the abdominal wall in the front and the peritoneal surface at
the rear.
The abdomen contains most of the tubelike organs of the digestive tract, as well as several solid
organs.
Hollow abdominal organs include the stomach, the small intestine, and the colon with its
attached appendix.
Organs such as the liver, its attached gallbladder, and the pancreas function in close association with
the digestive tract and communicate with it via ducts.
The spleen, kidneys, and adrenal glands also lie within the abdomen, along with many blood vessels
including the aorta and inferior vena cava.
Anatomists may consider the urinary bladder, uterus, fallopian tubes, andovaries as either abdominal
organs or as pelvic organs.
Finally, the abdomen contains an extensive membrane called the peritoneum. A fold of peritoneum
may completely cover certain organs, whereas it may cover only one side of (retroperitoneal) organs
that usually lie closer to the abdominal wall. Both the abdominal and pelvic cavities are lined by a
serous membrane known as the parietal peritoneum. This membrane is continuous with the visceral
peritoneum lining the organs.
Digestive tract: Stomach, small intestine, large intestine with cecum and appendix
Accessory organs of the digestive tract: Liver, gallbladder and pancreas
Urinary system: Kidneys and ureters - but technically located in retroperitoneum - outside
peritoneal membrane.
Other organs: Spleen.
In vertebrates, the abdomen is a large cavity enclosed by the abdominal
muscles, ventrally and laterally, and by the vertebral column dorsally. Lower ribs can also enclose
ventral and lateral walls. The abdominal cavity is upper part of the pelvic cavity. It is attached to
the thoracic cavity by the diaphragm. Structures such as the aorta, superior vena
3. cava and esophagus pass through the diaphragm. The abdomen in vertebrates contains a number
of organs belonging, for instance, to the digestive tract and urinary system.
Muscles
In human anatomy, the layers of the abdominal wall are (from superficial to deep):
Skin
Subcutaneous tissue
Fascia
Camper's fascia - fatty superficial layer.
Scarpa's fascia - deep fibrous layer.
Muscle
External oblique abdominal muscle
Internal oblique abdominal muscle
Rectus abdominis
Transverse abdominal muscle
Pyramidalis muscle
Fascia transversalis
Peritoneum
TYPES OF ABDOMINAL INJURIES:
A. PENETRATINGVs. BLUNT TRAUMA:
BLUNT TRAUMA :
Involves a direct blow (for example, a kick) , impact with an object (for example, a fall onto bicycle
handlebars), or a sudden decrease in speed (for example, a fall from a height or a motor vehicle crash).
Trauma to the abdomen is usually associated with extra – abdominal injuries ( i.e. chest, head &
extremity injuries) & severe concomitant trauma to multiple intraperitoneal organs. The spleen & liver
are the two most commonly injured organs. Hollow organs are less likely to be injured. Causes more
delayed complications, especially if there is injury to liver, spleen & blood vessels , which can lead to
substantial blood loss into the peritoneal cavity.
PENETRATING TRAUMA :
This implies that either a gunshot wound (or other high velocity missile/ fragment ), sharpe or a stub
wound has entered the abdominal cavity.
A gunshot wound is associated with high energy transfer & the extent of intraabdominal injuries is
difficult to predict. Shotgun injuries ,especially at close range, are frequently associated with massive
tissue damage & should be regarded as high energy transfer injuries.
Stab wound injuries can be inflicted by many objects other than knives, including knitting needles,
garden forks, wire, fence railing, pipes & pencils. Blunt or penetrating injuries may cut or rupture
abdominal organs & / or blood vessels. Blunt injury may cause blood to collect inside the structure of a
4. solid organ (for example the liver) or in the wall of a hollow organ (such as the small intestine). Such
collections of blood are called hematomas.
Cuts & tears begin bleeding immediately. More serious injuries may cause massive bleeding with shock
& sometimes death. Bleeding from abdominal injury is mostly internal (within the abdominal cavity).
When there is a penetrating injury, a small amount of external bleeding may occur through the wound.
When a hollow organ is injured, the contents of the organ (for example, stomach acid, stool, or urine)
may enter the abdominal cavity & cause irritation & inflammation (peritonitis).
B. CLASSIFICATION AS PER STRUCTUREINVOLVED:
The types of structures include
the abdominal wall
solid organs (liver, spleen, pancreas, or kidneys)
hollow organs (stomach , small intestine, bladder, colon, ureters)
blood vessels
Injuries to the Abdomen
ORGAN OR
TISSUE
COMMON INJURIES SYMPTOMS
Diaphragm Partially protected by bony structures, the
diaphragm is most commonly injured by
penetrating trauma (particularly gunshot
wounds to the lower chest)
Automobile deceleration may lead to
rapid rise in intra-abdominal pressure and
a burst injury
Diaphragmatic tear usually indicates
multi-organ involvement
Decreased breath sounds
Abdominal peristalsis heard in
thorax
Acute chest pain and shortness of
breath may indicate diaphragmatic
tear
May be hard to diagnose because
of multisystem trauma or the liver
may "plug" the defect and mask it
Esophagus Penetrating injury is more common than
blunt injury
May be caused by knives, bullets, foreign
body obstruction
May be caused by iatrogenic perforation
May be associated with cervical spine
injury
Pain at site of perforation
Fever
Difficulty swallowing
Cervical tenderness
Peritoneal irritation
Stomach Penetrating injury is more common than
blunt injury; in one-third of patients, both
the anterior and the posterior walls are
penetrated
May occur as a complication from
cardiopulmonary resuscitation or from
Epigastric pain
Epigastric tenderness
Signs of peritonitis
Bloody gastric drainage
5. ORGAN OR
TISSUE
COMMON INJURIES SYMPTOMS
gastric dilation
Liver Most commonly injured organ (both
blunt and penetrating injuries); blunt
injuries (70% of total) usually occur from
motor vehicle crashes and steering wheel
trauma
Highest mortality from blunt injury
(more common in suburban areas) and
gunshot wound (more common in urban
areas)
Hemorrhage is most common cause of
death from liver injury; overall mortality
10%–15%
Persistent hypotension despite
adequate fluid resuscitation
Guarding over right upper or lower
quadrant; rebound abdominal
tenderness
Dullness to percussion
Abdominal distention and
peritoneal irritation
Persistent thoracic bleeding
Spleen Most commonly injured organ with blunt
abdominal trauma
Injured in penetrating trauma of the left
upper quadrant
Hypotension, tachycardia,
shortness of breath
Peritoneal irritation
Abdominal wall tenderness
Left upper quadrant pain
Fixed dullness to percussion in left
flank; dullness to percussion in
right flank that disappears with
change of position
Pancreas Most often penetrating injury (gunshot
wounds at close range)
Blunt injury from deceleration; injury
from steering wheel
Often associated (40%) with other organ
damage (liver, spleen, vessels)
Pain over pancreas
Paralytic ileus
Symptoms may occur late (after 24
hr); epigastric pain radiating to
back; nausea, vomiting
Tenderness to deep palpation
Small intestines Duodenum, ileum, and jejunum; hollow
viscous structure most often injured by
penetrating trauma
Gunshot wounds account for 70% of
cases
Incidence of injury is third only to liver
and spleen injury
When small bowel ruptures from blunt
injury, rupture occurs most often at
proximal jejunum and terminal ileum
Testicular pain
Referred pain to shoulders, chest,
back
Mild abdominal pain
Peritoneal irritation
Fever, jaundice, intestinal
obstruction
Large intestines One of the more lethal injuries because of Pain, muscle rigidity
6. ORGAN OR
TISSUE
COMMON INJURIES SYMPTOMS
fecal contamination; occurs in 5% of
abdominal injuries
More than 90% of incidences are
penetrating injuries
Blunt injuries are often from safety
restraints in motor vehicle crashes
Guarding, rebound tenderness
Blood on rectal examination
Fever
Retroperitoneal
injuries:
Blunt or penetrating trauma to the
abdomen or posterior abdomen.
Kidney, ureters, pancreas, or
duodenal injuries.
Haemorrhage usually from
pelvic or lumbar fractures:
Gray turner’s sign – 12 hours
or later
cullen’s sign – 12 hours or later
Renal injuries Associated with posterior posterior
rib fractures & lumbar vertebral
injuries.
Deceleration forces may injure the
renal artery
PATHOPHYSIOLOGY:
Intra abdominal injuries secondary to blunt force are attributed to collisions between the injured person
& external environment & to acceleration or decelaration forces acting on the person’s internal organs.
Blunt force injuries to the abdomen can generally be explained by 3 mechanisms.
1. The first mechanism is decelaration. Rapid decelaration causes differential movement among
adjacent structures. As a result, shear forces are created & cause hollow, solid, visceral organs &
vascular pedicles to tear, especially at relatively fixed points of attachment. For example, the distal aorta
is attached to the thoracic spine & decelerates much more quickly than the relatively mobile aortic
arch. As a result, shear forces in the aorta may cause it to rupture. Similar situations can occur at the
renal pedicles & at the cervicothoracic junction of the spinal cord. Classic deceleration injuries include
hepatic tear along the ligamentam teres & intimal injuries to the renal arteries. As bowel loops travel
from their mesenteric attachments, thrombosis & mesenteric tears, with resultant splanchnic vessels
injuries, can result.
2. The second mechanism involves crushing. Intra abdominal contents are crushed between the
anterior abdominal wall & the vertebral column or posterior thoracic cage. This produces a crushing
effect, to which solid viscera (eg. spleen, liver, kidneys) are especially vulnerable.
3. The third mechanism is external compression, whether from direct blows or from external
compression against a fixed object (eg. lap belt, spinal column). External compressive forces result in a
7. sudden & dramatic rise in intraabdominal pressure & culminate in rupture of a hollow organ (i.e., in
accordance with the principles of Boyle law).
SYMPTOMS:
1. Pain or tenderness
Pain is often mild, & person may not notice or complain about it because of other more painful
injuries (such as fractures) or because the person is not fully conscious.
2. People may have lost a large amount of blood may have :
A rapid heart rate
Rapid breathing
Sweating
Cold, clammy, pale or bluish skin
Confusion or low level of alertness
3. Blunt trauma may cause bruising.
4. Cullen’s sign
5. Grey turner’s sign
6. Kehr’s sign
7. Shock.
COMPLICATIONS:
1. Hematoma rupture
2. Peritonitis
3. Intra abdominal collection of pus (abcess)
4. Intestinal blockage (obstruction)
5. Abdominal compartment syndrome
COLLABORATIVE MANAGEMENT:
HISTORY TAKING
For patients who have experienced abdominal trauma, establish a history of the mechanism of injury by
including a detailed report from the prehospital professionals, witnesses, or significant others. AMPLE
is a useful mnemonic in trauma assessment: Allergies, Medications, Past medical history, Last meal,
and Events leading to presentation. Information regarding the type of trauma (blunt or penetrating) is
helpful. If the patient was in an MVC, determine the speed and type of the vehicle, whether the patient
was restrained, the patient's position in the vehicle, and whether the patient was thrown from the vehicle
on impact. If the patient was injured in a motorcycle crash, determine whether the patient was wearing a
helmet. In cases of traumatic injuries from falls, determine the point of impact, the distance of the fall,
and the type of landing surface. If the patient has been shot, ask the paramedics or police for ballistics
information, including the caliber of the weapon and the range at which the person was shot.
PHYSICAL EXAMINATION
INVESTIGATIONS
8. Test Normal Result Abnormality With Condition Explanation
Contrast-enhanced
computed tomography
scan
Normal and
intact
abdominal
structures
Injured or ruptured organs;
accumulation of blood or air in
the peritoneum, in the
retroperitoneum, or above the
diaphragm
Provides detailed pictures
of the intra-abdominal
and retroperitoneal
structures, the presence of
bleeding, hematoma
formation, and the grade
of injury
Focused abdominal
sonogram for trauma
(FAST); four acoustic
windows (pericardiac,
perihepatic, perisplenic,
pelvic)
No fluid seen
in four
acoustic
windows
Accumulation of blood in the
peritoneum
Provides rapid evaluation
of hemoperitoneum;
experts consider FAST's
accuracy equal to that of
diagnostic peritoneal
lavage (DPL) (see below)
Diagnostic peritoneal
lavage (DPL); indicated
in spinal cord injury,
multiple injuries with
unexplained shock,
intoxicated or
unresponsive patients
with possible
abdominal injury
Negative
lavage without
presence of
excessive
bleeding or
bilious or fecal
material
Direct aspiration of 15 to 20 mL
of blood, bile, or fecal material
from a peritoneal catheter;
following lavage with 1 L of
normal saline, the presence of
100,000 red cells or 500 white
cells per mL is a positive lavage;
this is 90% sensitive for detecting
intra-abdominal hemorrhage
Determines presence of
intra-abdominal
hemorrhage or rupture of
hollow organs;
contraindicated when
there are existing
indications for
laparotomy
Other Tests:
1. Complete blood count: Normal haemoglobin & haematocrit results do not rule out significant
haemorrhage. Blood transfusions should not be withheld in patients who have relatively
normal haematocrit but have evidence of clinical shock, serious injuries or significant blood
loss.
2. Blood glucose determination: important for patients with altered mental status.
3. Urinanalysis: indications for diagnostic urinanalysis
4. Coagulation profile
5. Blood grouping, typing & cross matching
6. Arterial blood gas analysis
7. Drug & alcohol screens
8. Rigid sigmoidoscopy: is indicated for patients presenting with injuries in the pelvis or if
blood is found on rectal examination.
9. magnetic resonance cholangiopancreatography (MRCP) for the diagnosis of bile duct
injuries
10. chest, and cervical spine radiographs
11. Arteriographs
EMERGENCY DEPARTMENT CARE
Upon the patient’s arrival in the emergency department or trauma center, a rapid primary survey should
be performed to identify immediate life threatening problems.
9. a) The initial care of the patient with abdominal trauma follows the ABCs (airway, breathing,
circulation) of resuscitation. Measures to ensure adequate oxygenation and tissue perfusion
include the establishment of an effective airway and a supplemental oxygen source, support of
breathing,
b) Control of the source of blood loss, and replacement of intravascular volume.
c) Titrate intravenous fluids to maintain a systolic blood pressure of 100 mm Hg; overaggressive
fluid replacement may lead to recurrent or increased hemorrhage and should be avoided prior to
surgical intervention to repair damage. As with any traumatic injury, treatment and stabilization
of any life-threatening injuries are completed immediately.
MANGEMENT BASED ON ORGANS:
Diaphragmatic tears are repaired surgically to prevent visceral herniation in later years.
Esophageal injury is often managed with gastric decompression with a nasogastric tube,
antibiotic therapy, and surgical repair of the esophageal tear.
Gastric injury is managed similarly to esophageal injury, although a partial gastrectomy may be
needed if extensive injury has occurred.
Liver injury may be managed nonoperatively or operatively, depending on the degree of injury
and the amount of bleeding. Patients with liver injury are apt to experience problems with
albumin formation, serum glucose levels (hypoglycemia in particular), blood coagulation,
resistance to infection, and nutritional balance.
Management of injuries to the spleen depends on the patient's age, stability, associated injuries,
and type of splenic injury. Because removal of the spleen places the patient at risk for immune
compromise, splenectomy is the treatment of choice only when the spleen is totally separated
from the blood supply, when the patient is markedly hemodynamically unstable, or when the
spleen is totally macerated.
Treatment of pancreatic injury depends on the degree of pancreatic damage, but drainage of the
area is usually necessary to prevent pancreatic fistula formation and surrounding tissue damage
from pancreatic enzymes.
Small and large bowel perforation or lacerations are managed by surgical exploration and repair.
Preoperative and postoperative antibiotics are administered to prevent sepsis.
OPERATIVE MANAGEMENT:
Restrictive thoracotomy
Laparotomy & definitive repair
NUTRITIONAL:
Nutritional requirements may be met with the use of a small-bore feeding tube placed in the duodenum
during the initial surgical procedure or at the bedside under fluoroscopy. It may be necessary to
eliminate gastrointestinal feedings for extended periods of time depending on the injury and the surgical
intervention required. Total parenteral nutrition may be used to provide nutritional requirements.
NURSING MANAGEMENT:
Nursing Assessment
1. Assess for history of the injury, onset and progression of the symptoms.
2. Assess presence of signs and symptoms of internal bleeding or acute abdomen (pain, bowel
distention, muscle rebound) .
3. Assess abdomen wall for presence of wounds and hematomas.
10. 4. Assess vital signs, CVP, fluid balance and urine output.
5. Assess diagnostic tests and procedures for abnormal values (US, x-ray, CT, etc.).
Nursing Diagnosis
1. Increased risk of hypovolemia and shock related to abdominal trauma and internal bleeding..
2.Increased risk of sepsis related to acute inflammatory process and peritonitis.
3. Increased risk of severe fluid, electrolyte, and metabolic imbalances related to injury or inflammation.
4. Pain and bowel distention , related to diagnosis.
5.Risk for imbalanced body temperature related to damaged temperature-regulating mechanisms in the
brain
6. Risk for impaired skin integrity related to bed rest, hemiparesis, hemiplegia, immobility, or
restlessness
7. Deficient knowledge about abdominal injury, recovery, and the rehabilitation process
8. Anxiety related to the symptoms of disease and fear of death.
Goals:
1. Promote adequate respiratory and cardiovascular function.
2. Provide measures for prevention of the shock and sepsis.
3. Prevent avoidable injury and complications.
4. If surgical intervention prescribed, prevent postoperative complications.
5. Relief or diminish symptoms.
7. Decreased anxiety with increased knowledge of disease, it treatment, and follow-up.
Interventions
1. Assess, report , and record signs and symptoms and reactions to treatment.
2. Monitor fluids input and output closely, insert urinary catheter and IV catheter.
3. Provide positioning of the client in semi-Fowler position.
4. Monitor client for pain and signs of gastrointestinal decompensation.
5. Administer antibiotics and other medications as prescribed, monitor for side effects.
6. Monitor client’s vital signs and signs of possible hemorrhage, sepsis and shock closely, report
immediately.
7. Observe patency of tubes and drains, and drainage characteristics.
8. Monitor client’s laboratory tests results for abnormal values.
9. Keep client NPO as ordered.
10. Administer IV therapy and blood transfusions as prescribed.
11. Prepare client and his family for surgical intervention if required.
12. For client after surgical intervention provide postoperative care and teach about possible
postoperative complications.
13. Instruct client for cough and deep breathing to prevent respiratory complications.
14. Provide appropriate skin care to prevent possibility of skin lesions.
15. Provide emotional support to client, explain all procedures to decrease anxiety and to obtain
cooperation.
16. Instruct client regarding disease progress, diagnostic procedures, treatment and its complications,
home care, daily activities, restrictions and follow-up.
11. CONCLUSION:
Abdominal trauma can be life-threatening because abdominal organs, especially those in
the retroperitoneal space, can bleed profusely, and the space can hold a great deal of blood. 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. Hollow organs such as the stomach, while not as likely to result
in shock from profuse bleeding, present a serious risk of infection, especially if such an injury is not
treated promptly. Gastrointestinal organs such as the bowel can spill their contents into the abdominal
cavity. Hemorrhage and systemic infection are the main causes of deaths that result fromabdominal
trauma. One or more of the intra-abdominal organs may be injured in abdominal trauma. The
characteristics of the injury are determined in part by which organ or organs are injured. Abdominal
injury can be from mild to severe, depeding on that treatment also range from first aid to surgery with
lifelong rehabilitation. So health teaching to patient & family is very necessary to make the client able to
return in a normal life.
BIBLIOGRAPHY:
1. Smeltzer SC, Bare BG, Hinkle JL, Cheever KH. Textbook of medical-Surgical Nursing. 11th ed. New
Delhi:Wolters kluwer;2008. p. 2180-85.
2. Lewis LS, Heitkmper MM, Dirksen SR, Brien PG, Bucher L. Medical Surgical Nursing. 7th ed.
Noida: Elsevier;2009. P. 1485-89.
3.Black JM, Hawks JH. Medical Surgical Nursing. 8th ed. Noida: Elsevier;2009. P. 1933-39
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5.Abdominal trauma.Available in: https://en.wikipedia.org/wiki/Abdominal_trauma
6. Penetrating abdominal trauma.Available in: http://emedicine.medscape.com/article/2036859-treatment