The abdomen can be injured in many types of trauma; injury may be confined to the abdomen or be accompanied by severe, multisystem trauma. The nature and
... [Show More] severity of abdominal injuries vary widely depending on the mechanism and forces involved, thus generalizations about mortality and need for operative repair tend to be misleading.
Injuries are often categorized by type of structure that is damaged:
• Abdominal wall
• Solid organ (liver, spleen, pancreas, kidneys)
• Hollow viscus (stomach, small intestine, colon, ureters, bladder)
• Vasculature
Some specific injuries due to abdominal trauma are discussed elsewhere, including those to the liver, spleen and GU tract.
Etiology
Abdominal trauma is typically also categorized by mechanism of injury:
• Blunt
• Penetrating
Blunt trauma may involve a direct blow (eg, kick), impact with an object (eg, fall on bicycle handlebars), or sudden deceleration (eg, fall from a height, vehicle crash). The spleen is the organ damaged most commonly, followed by the liver and a hollow viscus (typically the small intestine).
Penetrating injuries may or may not penetrate peritoneum and if they do, may not cause organ injury. Stab wounds are less likely than gunshot wounds to damage intra-abdominal structures; in both, any structure can be affected. Penetrating wounds to the lower chest may cross the diaphragm and damage abdominal structures.
Classification:
Injury scales have been devised that classify organ injury severity from grade 1 (minimal) to grades 5 or 6 (massive); mortality and need for operative repair increase as grade increases. Scales exist for the liver, spleen, and kidneys.
Associated injuries:
Blunt or penetrating injury that affects intra-abdominal structures may also damage the spine and/or pelvis. Patients who experience significant deceleration often have injuries to other parts of the body, including the thoracic aorta.
Learning Objectives:
This study aims to provide an information and to give an example for how to plan a care for a patient diagnosed with blunt abdominal injury
Patient’s Profile:
Age: 21
Status: Single
Sex: Male
Religion: Islam
Date and Place of Birth: 11/29/1992/ Metro Manila
Date Admitted: 11- Aug – 2014
Time of Admission: 12:30am
Initial Diagnosis: Blunt Abdominal Injury sec to Trauma (06 Aug 2014)
Patient’s Health History
Patient came in w/ no airway obstruction, speaks in sentences, O2 sat of 97%; no difficulty of breathing but tachypneic at 28cpm; BP of 130/70mmHg w/ no episodes of hypotension; GCS 15 with both pupils equally reactice to light and accomodation. No other external sign of physical injury on back, axillae and groin.
PAST MEDICAL HISTORY
(-) HPN
(-) DM
(-) Bronchial Asthma
(-) Asthma
(-) thyroid dse
(-) PTB
(-) Food/drug allergy
FAMILY HISTORY
(-) HPN [Show Less]