What Are Different Types of Abdominal Injuries?

Most abdominal injuries have severe visceral damage at the same time. If it is accompanied by damage to the abdominal parenchymal organs or large blood vessels, it can lead to death due to major bleeding; when the cavity organs are damaged and ruptured, they can be life threatening due to severe abdominal infection. Early correct diagnosis and timely and reasonable treatment are the keys to reducing abdominal trauma deaths.

Basic Information

English name

abdominal injuries

English alias

surgical

Common locations

abdomen

Common causes

Impact injuries, firearm injuries, falls, injuries from swallowing foreign bodies, injuries from falling shots, corrosive strong acids, alkalis, or poisons.

Common symptoms

Abdominal pain, showing a tendency of continuous aggravation, accompanied by nausea and vomiting; Shock, high fever, chills and other infection symptoms

Causes of abdominal injuries

1. Impact injuries, crush injuries, sharp stab wounds, firearm injuries, fall injuries, swallowing foreign body injuries (metals) and other injuries.

2. Falling and scoring injuries.

3. Impact injury of air wave or water wave caused by severe explosion.

4. Chemical damage, such as corrosive strong acid, strong alkali or poison.

Clinical manifestations of abdominal injury

Abdominal pain

If you suspect an abdominal injury, first check the abdomen for tenderness and rebound pain.

2. shock

Early is due to pain and blood loss, and later is toxic shock.

3. infection

Patients may have high fever, chills, and elevated white blood cells in the blood.

Abdominal injury examination

(1) General inspection

1. Abdominal pain is severe, and there is a tendency of persistent pain and progressive aggravation, accompanied by nausea, vomiting and other gastrointestinal symptoms;

2. Those who have obvious early manifestations of hemorrhagic shock;

3. People with obvious signs of peritoneal irritation (abdominal tenderness, muscle tension and rebound pain);

4. Those who have accumulated gas in the abdominal cavity and have reduced or disappeared liver dullness;

5. Abdominal flatulence, weakened or disappeared intestinal motility;

6. Mobile dullness appears in the abdomen;

7. Patients with blood in the stool, vomiting, or hematuria; those who have tenderness or fluctuation in the anterior wall by digital rectal examination, or those who have blood stains on their fingers.

(Two) auxiliary inspection

Laboratory inspection

When there is substantial rupture of organs in the abdomen and bleeding, the values of red blood cells, hemoglobin, hematocrit and the like decrease significantly, and the white blood cell count may increase slightly. When the cavity organs ruptured, the white blood cell count increased significantly. When pancreatic injury, stomach or duodenal injury, blood and urine amylase values are increased. Routine urine examination revealed hematuria, suggesting urinary organ damage.

2.B ultrasound

B-ultrasound is highly valued in the diagnosis of abdominal injury. Intrahepatic hematomas with a diameter of 1 to 2cm can be found, and the discontinuity and parenchymal rupture of the organ capsule can be found. The rate of peritoneal effusion was high by ultrasound. The amount of peritoneal effusion can be estimated according to the B-ultrasound, that is, about 500ml of peritoneal effusion per lcm of fluid. Due to the strong reflection of the gas on the ultrasound, it appears as a bright area on the sonogram. Therefore, B-ultrasound can also detect gas accumulation in the abdominal cavity, which is helpful for diagnosis of cavity organ rupture or perforation.

3.X-ray inspection

Selective X-rays are valuable for the diagnosis of abdominal injuries. Commonly used are chest radiographs, supine positions, and left abdominal flat films. Although a flat abdominal film is more meaningful, it is not suitable for severely injured people. Take positive and lateral pelvic radiographs as needed.

4.CT inspection

CT has higher resolution of soft tissues and parenchyma. CT can clearly show whether the capsules of liver, spleen, and kidney are intact, and the size and morphology are normal, which is valuable for the diagnosis of substantial organ damage.

5. Diagnostic laparotomy and lavage

Observe the characteristics of the liquid after pumping the liquid, and infer the type of damaged organ; if necessary, perform microscopy and smear inspection. Contraindications: Severe intra-abdominal flatulence, long-term pregnancy, extensive intra-abdominal adhesions, and restlessness.

Abdominal injury treatment

Patients with ruptured abdominal organs should be treated in time. For non-surgical treatment, if the internal organ damage cannot be ruled out after observation, or if the following conditions occur during the observation period, the observation should be terminated and a laparotomy should be performed.

1. Patients with abdominal pain and peritoneal irritation that are progressively aggravated or enlarged in scope;

2. Intestinal motility sounds gradually decrease, disappear, or obvious abdominal distension;

3. The general condition has a tendency to worsen, and thirst, irritability, increased pulse rate, or increased body temperature and white blood cell count;

4. Those who show free gas under their crotch;

5. Progressive decrease in red blood cell count;

6. People whose blood pressure has changed from stable to unstable or even shocked; or those who are not in good condition but continue to worsen during the process of actively managing shock;

7. Gastrointestinal bleeding is not easy to control.

A small number of wounded people may have negative detection results, but abdominal internal organ injuries have been missed and some have led to death. Once the surgery is decided, the pre-operative preparation should be completed as soon as possible: establish an unobstructed infusion channel, cross-match blood, and place nasogastric tubes and urinary tubes. If there is shock, quickly enter the equilibrium fluid to replenish blood volume.