Solid and hollow organ injuries may occur in abdominal trauma patients. With blunt trauma, splenic lacerations are the most common injury followed by liver lacerations. Bladder rupture can also be encountered. Intestinal injuries, although less common, may also be present Blunt abdominal injuries often managed conservatively, though interventional radiology and surgery are indicated for severe injuries Common mechanisms include road traffic crashes, falls, sports injuries and assaults organs most affected are : spleen > liver > small and large intestin Most commonly injured organ in penetrating abdominal trauma. Abdominal pain, localized tenderness (RUQ) Possible hemorrhagic shock. CT abdomen with IV contrast is the investigation of choice (liver injuries are graded I to VI according to severity) Management. Most hemodynamically stable injuries can be managed non-operatively
Most common MOI for penetrating trauma of abdomen? 1) GSW 2) Stab wounds 3) Flying projectiles. Most commonly injured organ in blunt abdominal trauma? Common finding? Spleen/ hypotension. Confusion is seen with >30% blood loss. Kehr's sign? Left shoulder pain when legs are elevated 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 the peritoneum and if they do, may not cause organ injury The small bowel is the organ most commonly injured by penetrating abdominal trauma. Pancreatic injury is more common with penetrating than blunt abdominal trauma, and there is a high incidence of diaphragmatic injury in thoracoabdominal penetrating trauma
Penetrating injuries often result in injury to hollow organs, such as the intestines. The liver is the most commonly injured solid organ. Gunshot wounds are classified as high energy and may result in extensive damage, especially if the bullet ricochets off of bone. Patients are at increased risk for both hemorrhage and peritonitis, especially with intestinal injury The liver is the second most frequently injured abdominal organ after blunt trauma, resulting in? -subcapsular hematomas and/or laceration of intraparenchymal vessels -progressing to hepatic avulsion (separation of the hepatic vasculature) or parenchymal disruptio Penetrating abdominal trauma Penetrating injuries tend to be obvious and dramatic. The most commonly injured intra-abdominal organs are the small intestine, liver and colon. Of these only one third will penetrate the peritoneum & only 50% of these will require surgical intervention Blunt trauma happens when a force strikes the abdomen without penetrating it. Hitting the seatbelt during a car accident qualifies as blunt trauma. Likewise, impacting the ground after a fall can cause blunt trauma. Blunt trauma can rupture blood vessels and organs. The organs most likely to suffer damage from blunt trauma include the spleen.
Nevertheless, penetrating abdominal organ injury patterns and survival have plateaued over the past decade. Death from refractory hemorrhagic shock or exsanguination in the first 24 hours remains the most common cause of mortality Spleen is the most common cause of massive bleeding in blunt abdominal trauma to a solid organ. Spleen is the most commonly injured organ. A laceration of the spleen may be associated with hematoma. Because of the spleen's ability to bleed profusely, a ruptured spleen can be life-threatening, resulting in shock
Pediatric abdominal trauma is typically blunt in nature with the spleen being the most common organ injured. Nonoperative management is employed in over 95% of patients. Penetrating injuries are less common but often require operative management. Knowledge of specific mechanisms of injury aids the clinician in the diagnosis of specific injuries Trauma Notes GI Trauma Liver o Most common organ injured in penetrating trauma. o 2 nd most common in blunt trauma. Ribcage protects the liver. o S/S RUQ pain Abdominal tenderness & guarding Kher's Sign - Referred right shoulder pain = liver o Assessment Inspection for ecchymosis (bruising) Abdominal CT scan Grade I - VI o Treatment Stable: non-operative management Watch & wait. Looking at. In the prospective analysis of abdominal solid organ injuries published by Demetriades in 2006, it was found that 14.9% of all penetrating kidney injuries were managed successfully without operation and that 30.4% of those with penetrating renal trauma had no other significant intraabdominal injuries  Penetrating trauma is an injury caused by a foreign object piercing the skin, which damages the underlying tissues and results in an. open wound. . The most common causes of such trauma are gunshots and stab wounds. Clinical features differ depending on the injured parts of the body and the shape and size of the penetrating object
Penetrating trauma is a common presenting complaint with the potential for devastating consequences. The diagnostic and therapeutic management of penetrating injuries to the chest and abdomen has undergone substantial evolution. The authors discuss the advances in the care of patients with penetrating chest and abdominal trauma Introduction 15-20% of all trauma deaths Liver most commonly injured abdominal organ Spleen most frequent in sports injuries Patients who survive initial traumatic insult suffer mortality and morbidity as a result of sepsis Blunt trauma MVA most common Injury is common at transition between mobile and fixed regions Ligament of Trietz and distal small bowel represent transition areas where. Abdominal injuries are divided into tw o broad categories based on the mechanism of injury, blunt and penetrating. Blunt trauma is the most common injury pattern with motor vehicle crashes being the most common mechanism accounting for approximately 75%. Diagnosing blunt abdominal trauma can be very challenging. It is often difficult t
Retroperitoneal injuries are among the most lethal injuries sustained by trauma patients and the most common modes of injury include automobile accident, fall from height, interpersonal conflicts and animal hits8. Retroperitoneal organ injuries are known to occur in a significant minority of blunt abdominal Liver is the most common organ injured in the multiple organ injury. In total three cases are involved in injury. In this study, the most common injured organ alone in BAT was liver followed by spleen, whereas the most common injured organ alone in penetrating abdominal trauma was small bowel Abdominal trauma (not always penetrating) • The most commonly injured abdominal organ injured in sports • - & cause of death d/t sports-related abdominal trauma other more common abdominal injuries) - ERCP is better for evaluating the pancreatic duct but is an invasive
Organs most often injured Frequency of Organ Injury Blunt Penetrating Liver 15% 22% Spleen 27% 9% Pancreas 2% 6% Kidney 27% 9% Stomach 1% 10% Duodenum 3% 4% Small Bowel 6% 18% Colon 2% 16% Other 17% 6% Saxena, et al, Medscape Reference, May 9,201 . 1 In blunt force abdominal trauma, the spleen and liver are the most commonly injured organs, with a mortality rate of roughly 8.5%. 2 Nearly three-quarters of.
.8%) had blunt abdominal injury, with a blunt-to-penetrating ratio of 2.7:1. The most common cause of injury was road traffic accidents (RTAs; 73 patients; 53.7%). Commonly injured organs in blunt and penetrating injuries were, respectively, the spleen (33 patients; 91.7%) and small bowel (12 patients; 46.1%) Abdominal trauma remains a leading cause of mortality in all age groups. Blunt abdominal injury (BAI) is common and usually results from motor vehicle collisions (MVC), falls and assaults. In children (less than or equal to 14 years of age), blunt abdominal trauma is the second most frequent cause of mortality preceded by head injuries Table 3. Association of type of injury with number of organs injured . Number of organ injury Total One organ injured More than one organ injured Type of injury Penetrating injury 18 50 68 Blunt injury 32 0 32 50 50 100 P-value: 0.002. rate in this study was 2%. All deaths were related to road traffic accident wherea
Approximately 90% of abdominal trauma is blunt and 10% is penetrating. 3 Blunt abdominal trauma is the third most common cause of pediatric trauma-related deaths. 3,6 The spleen and liver are the most frequently injured organs, followed by the kidney, small bowel, and pancreas Abdominal injuries are found in 20-30% of patients with multi-organ injuries. Common causes of abdominal injury include blunt trauma (motor vehicle accidents (MVAs) and falls), and penetrating trauma (gunshot wounds (GSWs) and stabbings). Common abdominal organ injuries involve the liver, spleen, kidneys, intestines and vasculature Flank and back stab wounds are associated with 15%-40% intraperitoneal organ injury 4; Gunshot wounds are responsible for 90% mortality in penetrating trauma 2. 80% gunshot wounds enter the peritoneal cavity ; Most commonly injured organs, in order of decreasing incidence: small bowel, colon, liver, abdominal vasculatur
Fig 1. RCH abdominal injury admissions by mechanism, 2000-2003 (n=220) Table 1. Abdominal injuries by injury type. 30% of patients with abdominal injuries had an injury to one or more other body regions. How children are different. Abdominal organs are relatively susceptible to injury because Commonest organ involved was spleen (40.9%) followed by liver (22.7%), small intestine (18.2%), mesentery (13.6%) of total intra-abdominal injuries in blunt abdominal trauma and colon and rectum (20%) was the most common organ involved in penetrating trauma. 7.5% had associated chest injury with fracture ribs The type of abdominal trauma was found significantly associated with liver injury (p-value 0.021), and intestine injury (p-value <0.001). Conclusion Penetrating trauma (51.4%) was more common than blunt trauma (48.5%), and intestines are the most commonly affected by penetrating and blunt trauma injuries (70.1% and 47.8%, respectively) . If the CT scan is positive, then the next step is either non-operative management or an exploratory laparotomy, depending on the type and severity of the injury
Torso Trauma • Both the spleen and the liver are located within the thoracic cage • Lower rib fractures are frequently associated with liver and spleen injuries • The diaphragm changes its position during the respiratory cycle. • Penetrating chest injuries below the 5th intercostal space may traverse the diaphrag . Regarding mechanism, the type of penetrating weapon or object, the range and trajectory from which the injury occurred, which organs may be injured, and the location and number of wounds, are all crucial to consider
The spleen is among the most commonly injured organs in blunt abdominal trauma, accounting for up to 49% of all visceral injuries, with rates of injury in penetrating abdominal trauma less than that of other organs such as the liver and bowel. 3,4 A substantial portion of penetrating splenic injury arises from inadvertent intraoperative injury. Since most people are right-handed and hold the offending instrument in their right hand, the LUQ is most commonly injured in stab wounds. However, the liver occupies the most space in the abdomen and therefore is the most common organ injured.The small bowel is the second most commonly injured organ in stab wounds and is the most common organ injured in projectile penetrating abdominal trauma. the abdomen, the ret rope ritoneum and into muscle compartments. Which organ is the most commonly damaged in penetrating injury of abdomen!n penetrating injury, liver is the most common organ injured and small intestine is the second most common organ injured Pancreatic Trauma Definition. The term pancreatic trauma refers to injury of the pancreas, the elongated gland that sits in the upper middle quadrant of the abdomen. This can occur with blunt force trauma or sharp penetrating injuries. The pancreas is among the more commonly injured organ as it has very limited protection from the ribcage and is therefore quite exposed in the abdomen
Solid organ injury (liver and spleen, typically) is a common diagnosis after blunt trauma. Most trauma centers have protocols for VTE prophylaxis which apply to patients with those injuries. Older literature that I wrote about eight years divided the time frames for prophylaxis into early (within 3 days), late (greater than 3 days), and none A Nigeria study done in Gombe Federal Teaching Hospital, penetrating abdominal trauma was seen in the majority (62.9%) of patients. Stab (28.1%) and road traffic accidents (30,3%) were the commonest causes. Spleen (29.8%) was the most common isolated injured organ while the small bowel and the colon (40.7%) were the most injured in combined trauma r abdomen between January 1983 and April 2001. Results: Forty-nine children (34%) with penetrating anterior abdominal wounds had retroperitoneal organ injury. The most injured organs were the descending colon in 17 patients (35%), ascending colon in eight patients (16%), and kidney in seven (14%). The most commonly associated injured organ was the small bowel. Postoperative septic. Blunt trauma refers to injury of the body by forceful impact with a dull object. With blunt force trauma, there can be internal organ injuries that are not immediately visible. Common organs that are affected include the spleen, liver, and small intestine. Injuries to internal organs can lead to hemorrhage and sudden drop in blood pressure Despite recent decreases in firearm injuries nationally, gunshot wounds (GSW) remain the most common cause of penetrating trauma in children and adolescents3. The incidence of firearm injuries rises dramatically beginning at age 12 and peaks earlier than other mechanisms (eg, motor vehicle collisions) at age 19
major vascular injury, diaphragm injury, or operative solid organ injury. Note that isolated solid organ injuries (liver, spleen, kidneys) without clinical or radiologic evidence of an associated operative injury may be managed per standard blunt solid organ injury nonoperative management guidelines. J Trauma Acute Care Sur Blunt abdominal trauma (BAT) represents 75% of all blunt trauma and is the most common example of this injury. The majority occurs in motor vehicle accidents, in which rapid deceleration may propel the driver into the steering wheel, dashboard, or seatbelt causing contusions in less serious cases, or rupture of internal organs from briefly increased intraluminal pressure in the more serious. Liver trauma is responsible for the majority of penetrating abdominal trauma and is the third most common injury caused by firearms. Presenting a 20% mortality rate, it is an organ with wide and complex vascularization, receiving blood from the hepatic veins and portal vein, as well as from the hepatic arteries. The diagnosis is not always simple in polytrauma patients and contains a wide.
Injuries of the biliary system are rare. They can broadly be divided into traumatic biliary injuries and iatrogenic biliary injuries. Former are usually part of associated abdominal trauma, blunt or penetrating, and latter are consequence of surgical, endoscopic or invasive radiological diagnostic or therapeutic procedures done in various liver, pancreatic or disorders or the part of upper. Pearls. Trauma patients with hemodynamic changes with a negative chest x-ray, E-FAST, and pelvic x-ray should be presumed to have retroperitoneal trauma until proven otherwise.; The most common cause of retroperitoneal trauma is secondary to zone 3 injuries in the pelvis.Use pelvic binders to stabilize pelvic ring fractures at the bedside, and rapid transition to extra-peritoneal packing to. Blunt injury accounts for 90% of abdominal trauma in children. Common mechanisms include motor vehicle collisions, automobile versus pedestrian crashes, falls, bicycle crashes, and nonaccidental trauma. In pediatric blunt abdominal trauma, solid viscus organs such as the liver, spleen, and kidney are more frequently injured than hollow viscus. Abdominal Trauma DRG Category: 326 Mean LOS: 15.4 days Description: SURGICAL: Stomach, Esophageal, and Duodenal Procedure with Major CC DRG Category: 394 Mean LOS: 4.4 days Description: MEDICAL: Other Digestive System Diagnoses with CC Abdominal trauma accounts for approximately 15% of all trauma-related deaths. Intra-abdominal trauma is. The kidneys are the most commonly injured organs following pediatric blunt abdominal trauma .The Committee on Organ Injury Scaling (OIS) of AAST, in 1989, has developed a widely accepted grading scale in which renal injuries are divided in to five grades as shown in table 1 which also ensures a common consensus between surgeons and.
Trauma. Trauma in the medical sense means any injury to human tissues and organs caused by an external force. Trauma includes all injuries caused by an external force, from minor (cuts and bruises) to critical (major brain or spinal injuries). Trauma is usually categorised as blunt or penetrating The small bowel is the most frequently injured organ after penetrating injuries.The colon is the second most frequently injured organ after gunshot wounds and the third after stab wounds to the abdomen. Suspicion of a splenic injury should be raised in any patient with blunt abdominal trauma Traumatic diaphragmatic injuries are a rare entity and can occur in relation to penetrating thoracic and abdominal trauma. The most common clinical features of diaphragm rupture include chest or abdominal bruising, decreased breath sounds, and signs of bowel obstruction. However, the classic signs and symptoms of diaphragmatic injury are not always present and can be obscured even in the.
The most common etiology of hemorrhagic shock in the trauma patient is intraabdominal bleeding. Early deaths from abdominal injury are from bleeding. Late deaths are from intraabdominal sepsis, most often from hollow organ injury. 1 Remember that injuries rarely occur in isolation; injuries occur as a component of a pattern of injuries Abdominal vascular trauma, primarily due to penetrating mechanisms, is uncommon. However, when it does occur, it can be quite lethal, with mortality ranging from 20% to 60%. Increased early mortality has been associated with shock, acidosis, hypothermia, coagulopathy, free intraperitoneal bleeding and advanced American Association for the Surgery of Trauma Organ Injury Scale grade Abstract: Purpose: To evaluate the causes, pattern and outcome of management of penetrating abdominal trauma.Methods: A retrospective analysis of 26 patients with penetrating abdominal injuries was done from 2012-2014.Results: The most common age group was 3rd decade of life with 10(38.5%) patients, with all 26 patients included in the study being males
The pathophysiology of penetrating trauma depends on the energy of the injury and the type of projectile. In a study of injuries from the 1991 Gulf War, shrapnel injuries all affected soft tissue, one third caused bony injury, and only 10% caused abdominal or thoracic visceral injury. 6 A stab wound imparts relatively little energy, and injury depends on the size of the weapon used The bowel and mesentery are injured in ~2.5% (range 0.3-5%) of blunt force abdominal trauma 1,3,5,8. However not surprisingly, bowel and mesenteric injuries are more frequent after penetrating trauma 8. Bowel injury has consistently been found to be the most common traumatic abdominopelvic injury missed on CT 11 It is more common than penetrating abdominal trauma. Penetrating abdominal trauma that arises from stab wounds and gunshot wounds. The most commonly injured intra-abdominal organ is the spleen, followed by the liver and the genitourinary organs. The management of a patient with abdominal trauma involves Blunt trauma is most commonly due to motor vehicle accidents and is a major cause of morbidity and mortality in all age groups. The most common signs of significant abdominal trauma are pain, irritation. The patterns of chest injury are highly dependent on the intensity of the trauma and may vary from harmless In Europe, the majority of abdominal injuries are caused by blunt trauma, mostly secondary to traffic accidents, falls and interpersonal violence. Of penetrating injuries, gunshot wounds dominate in the United States whereas stab wounds are more common in Finland and South Africa, for example. A patient may also have and internal abdominal organ injury even if the stab or gunshot inlet wound. Common causes of missed injuries in the patients undergoing surgery due to penetrating abdominal trauma include insufficient surgical exploration, poor surgical techniques, and the lack of surgical experience [5, 11]. During surgery, optimal exposure of intraabdominal organs should be achieved to avoid missed injuries