Acute Abdominal Trauma
What is Acute Abdominal Trauma?
A sudden and severe injury to the abdomen is referred to as acute abdominal trauma. Damage can occur to the abdominal wall, the vasculature of the abdomen (blood vessels) and internal organs such as the stomach, spleen, liver, pancreas and intestine. Internal bleeding may occur if injury is severe.
- Blunt Trauma: Injury is caused by a blunt force such as a kick or a direct blow to the abdomen by an object, vehicle accidents or fall from a height. The injury is not always visible from outside the abdomen. Damage to the stomach, spleen, liver and small intestine can occur.
- Penetrating Trauma: Injury is caused by the penetration of an object inside your abdomen. The injury is visible from outside and is usually caused by gunshots, stabbing or fall on a sharp object.
Symptoms
Symptoms may vary depending on the type and severity of the trauma. Common symptoms can include:
- Headache and dizziness
- Abdominal pain
- Stomach tenderness and irritation
- Bowel obstruction
- Nausea and vomiting
- Haemorrhage (internal or external)
- Biliary leakage
- Signs of shock such as elevated heartrate, low blood pressure, confusion, clammy skin etc.
Diagnosis
Your doctor will ask a few questions about the injury and perform a physical exam of the abdomen. The following tests may be ordered:
- Imaging tests: CT-scan or MRI will be ordered to check for internal bleeding and injury to abdominal organs. You may need to swallow a contrast preparation or have an IV line started in your arm if the CT scan involves contrast dye. Inform your technician if you have or feel any allergy symptoms such as sneezing or itching.
- Angiography: This is a test that examines the blood vessels of your abdomen. A contrast dye is injected into the artery while x-ray images are taken.
- Focused Assessment with Sonography (FAST) or Abdominal ultrasound: An ultrasound is a diagnostic imaging technique that transmits sound waves into your body and processes the waves that bounce off body structures to create images or video of the inner structures. Abdominal ultrasound is used to image the internal organs of the abdomen.
- Blood tests: Complete blood count (CBC) and other tests may be ordered.
Treatment
Your doctor will prescribe pain medicines as needed. Use of ice packs may be suggested to reduce inflammation. You will be advised to limit your activities. A brief course of antibiotics is prescribed to manage infection.
Severe injuries require surgery and can involve one or more of the following procedures:
- Laparotomy: It is an open surgery to check the internal injuries of the abdomen prior to major surgery. Blunt abdominal trauma usually requires a laparotomy.
- Removal of Gunshot residue: In the case of gunshots, immediate surgery is performed to remove the residue in the abdomen.
- Resection and Anastomosis: Severe injuries to a part of the small intestine can be surgically treated by resection and anastomosis. The damaged part is resected and the intestine is reconnected by creating two new communications or anastomoses.
- Liver Surgery: Damage control surgery may be performed to manage bleeding and infection. Liver resection or liver transplantation may be required in cases of severe injury.
- Spleen Surgery:Surgical sutures may be used to repair a ruptured spleen. A part of the spleen or the complete spleen may be removed in cases of severe damage.
- Gallbladder Surgery:Injuries of the gallbladder may be treated by cholecystectomy.
