This document discusses torso trauma, including the mechanisms and causes of injury to the thorax and abdomen. It notes that torso trauma often affects both cavities due to their proximity. Blunt injuries are caused by distributed forces while penetrating injuries are from localized impacts. Common causes of blunt trauma are motor vehicle accidents and falls, while gunshot and stab wounds often cause penetrating trauma. Injuries can disrupt organs directly or cause bleeding and inflammatory reactions. The spleen is most commonly injured in blunt abdominal trauma while the liver is most common in penetrating abdominal trauma. Gunshot wounds frequently injure the small intestine.

1. INJURY MECHANISM
ASSOCIATED WITH
TORSO TRAUMA
DEVKUMAR
SAHU
ROLL 22
DEPARTMENT OF
SURGERY

2. CONTENTS-
➢ BASE OF TORSO
TRAUMA
➢ MECHANISM OF INJURY
OF TORSO TRAUMA
➢ CAUSES OF INJURIES
➢ PATHOPHYSIOLOGY
OF TRAUMA
➢ SPECIAL POINTS
REGARDING THORACIC
TRAUMA
➢ SPECIAL POINTS
REGARDING
ABDOMINAL TRAUMA
➢ BIBILIOGRAPHY

3. Base of Torso Trauma-
• Abdominal and thoracic injuries along with the pelvis should
be considered as one complex – TORSO TRAUMA.
• Injury often traverses different anatomical zones of the body,
affecting structures on both sides of anatomical zones.
These are known as JUNCTIONAL ZONES.
• Injury impacting at the thoracic cavity can also affect the
abdominal organs and vice versa, so the examination of both
the cavity is important in case of trauma impacting either of
these regions.

4. Diagram
showing why
both cavity
should be
suspected
for injury !

5. Mechanism of Injury of Torso
Trauma-
• Blunt injuries
• Force distributed over large area.
• Penetrating injuries
• Force distributed over small area
• Organs injured are those that lie along the
path of penetrating object.

6. Causes Of Injuries
BLUNT
TRAUMA
PENETRATIN
G TRAUMA
IATROGENIC
TRUAMA
1. Motor Vehicle
Accidents. (50-
70% cases)
2. Blows to
abdomen.
(15%)
3. Falls. (6-9%)
4. Blast Injuries.
1. Gunshot
Wounds
2. Stab wounds.
3. Shrapnel
wounds.
1. Endoscopic
procedure.
2. Paracentesis &
thoracocentesis
3. Biopsy

7. PATHOPHYSIOLOGY OF TORSO
TRAUMA-
• Blunt Trauma
• Results from kinetic energy
forces.
• Subdivision of Blunt Trauma
Mechanism
• Blast
• Crush (Compression)
• Deceleration
• Penetrating Trauma
• Low energy trauma
• High energy trauma
• Iatrogenic Trauma
• Localized to the region
where investigated or
treatment is being
performed.

8. Blast
Mechanism-
❑Pressure wave
causes tissue
disruption.
❑Tearing of
vessels and
alveolar tissue.
❑Traumatic
diaphragm
rupture.
Blunt Trauma continue

9. Crush
(Compression
mechanism)
❑Body is
compressed
between an
object and hard
surface.
❑Direct injury of
chest wall and
internal
structures.
Blunt Trauma continue

10. Deceleration-
❑ Body in motion
strikes a fixed
object.
❑ Thoracic or
abdominal Wall stop
moving but the
internal organs
continue in motion.
❑ Eg. Ligamentum
Arteriosum shears
Aorta.
Blunt Trauma continue

11. • Rib fracture is most common sign of Blunt
Thoracic Trauma.
Fracture of Scapula, Sternum or first rib indicates
massive force of injury.

12. Penetrating
Trauma
Low Energy
❑Arrows, knives,
handguns.
❑Injury is caused
by direct contact
and cavitation.
Penetrating Trauma continue

13. Penetrating
Trauma
High
Energy
❑Rifles & high
powered hand
guns.
❑Extensive
injury due to
high pressure
cavitation.
Penetrating Trauma continue

14. Hollow Organ
Injuries
❑Rupture of the
hollow organ can
spill the content
into thoracic and
abdominal cavity
leading to painful
inflammatory
reaction or
peritonitis.

15. Solid Organ
Injuries
❑Can cause
severe internal
bleeding.
❑Hemothorax,
pneumothorax,
liver injury.
❑Blood in
peritoneal cavity
causes
peritonitis.

16. Special
points
regarding
Thoracic
trauma
❑most common
cause of Blunt
thoracic injury
leading to death –
Tracheo-
bronchial injury.

17. Special points
regarding
Thoracic
trauma
❑ most common
cause of
Penetrating
thoracic injury
leading to death –
hemothorax due
to pulmonary
lacerations.

18. Special points regarding
Abdominal trauma
• most common organ involved in Blunt
Trauma is Spleen.
• most common organ involved in penetrating
Trauma is Liver.
• most common organ involved in gun shot
injury is Small intestine.
• most common organ involved in deceleration
injury is Duodeno-Jejunal flexure.

19. BIBILIOGRAPHY-
SABINSTON – TEXTBOOK OF SURGERY
BAILEY AND LOVE
SRB’S
MANIPAL