Abdominal Injury

Abdominal Injury

Abdominal injuries are divided into two injuries :-

  1. Blunt injuries (non penetrating injuries).
  2. Penetrating injuries.

Blunt and penetrating abdominal injuries may damage major blood vessels as well as internal organs. Their most immediate life-threatening consequences are hemorrhage and hypovolemic shock; later threats include infection. The prognosis depends on the extent of injury and on which organs are damaged, but it’s generally improved by prompt diagnosis and surgical repair.

Causes

  • Blunt (non penetrating) abdominal injuries usually result from motor vehicle accidents, falls from heights, or athletic injuries.
  • Penetrating abdominal injuries are caused from stab and gunshot wounds.

Signs and symptoms

Depending on the degree of injury and the organs involved, symptoms vary as follows:

  • Penetrating abdominal injuries cause obvious wounds. For example, gunshots often produce both entrance and exit wounds, with variable blood loss, pain, and tenderness. These injuries often cause pallor, cyanosis, tachycardia, shortness of breath, and hypertension.
  • Blunt abdominal injuries cause severe pain (such pain may radiate beyond the abdomen, for instance, to the shoulders), bruises, abrasions, contusions, or distention. They may also result in tenderness, abdominal splinting or rigidity, nausea, vomiting, pallor, cyanosis, tachycardia, and shortness of breath. Rib fractures often accompany blunt injuries.

In both blunt and penetrating injuries, massive blood loss may cause hypovolemic shock. In general, damage to solid abdominal organs (liver, spleen, pancreas, and kidneys) causes hemorrhage; damage to hollow organs (stomach, intestines, gallbladder, and bladder) causes rupture and release of the organs contents (including bacteria) into the abdomen, which, in turn, produces inflammation.

Home remedies for the treatment of injuries

Blunt abdominal injuries

  • Apply heat for example with a hot water bottle or with electric heating belt(after the first 48 hours of injury).
  • If the pain is high up in your abdomen and occurs after meals, antacids may provide some relief, especially if you feel heartburn or indigestion. Avoid citrus, high-fat foods, fried or greasy foods, tomato products, caffeine, alcohol, and carbonated beverages.
  • Take help of sports injuries specialist who could tell some exercises.

However no home remedies is available for penetrating injuries. This injuries require emergency treatment to control hemorrhage and prevent hypovolemic shock, by infusion of I.V. fluids and blood components. After stabilization, most abdominal injuries require surgical repair; some patients, however, require immediate surgery. Analgesics and antibiotics increase patient comfort and prevent infection. Most patients require hospitalization; if they’re asymptomatic, they may require observation for only 6 to 24 hours.

Diagnosis

A history of abdominal trauma, clinical features, and laboratory results confirm the diagnosis and determine organ damage. Consider any upper abdominal injury a thoracicoabdominal injury until proven otherwise. Diagnostic studies vary with the patient’s condition but usually include:

  • chest X-rays (preferably done with the patient upright, to show free air)
  • examination of stool and stomach aspirate for blood
  • blood studies (decreased hematocrit and hemoglobin levels point to severe blood loss; coagulation studies evaluate hemostasis; white blood cell count is usually elevated but doesn’t necessarily point to infection; type and cross match to prepare for blood transfusion).
  • arterial blood gas analysis to evaluate respiratory status
  • serum amylase levels, which often may be elevated in pancreatic injury
  • aspartate aminotransferase and alanine aminotransferase levels, which increase with tissue injury and cell death .
  • excretory urography and cystoure­thrography to detect renal and urinary tract damage.

Prevention

  • Eat small meals more frequently.
  • Drink plenty of water each day.
  • Apply a sterile dressing to open wounds. After assessing the patient, splint a suspected pelvic injury by tying the patient’s legs together with a pillow between them. Try not to move the patient.
  • Exercise regularly.

Useful References

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