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KMID : 0352119950110020128
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Journal of Kyung Hee University
1995 Volume.11 No. 2 p.128 ~ p.135
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Abdominal Trauma in Advanced Trauma Life Support
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Abstract
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Unrecognized abdominal injury remains a distressingly frequent cause of preventable death after trauma. Peritoneal signs are often subtle, overshadowed by pain from associated extra-abdominal trauma, or masked by head injury or intoxicants. As
many
as
20% of patients with acute hemoperitoneum have benign abdominal findings when first examined in the emergency department. Moreover, the peritoneal cavity is a potential reservoir for major occult blood loss. Any patient sustaining significant
deceleration injury or a penetrating torso wound must be assumed to have an abdominal visceral injury. Peritoneal lavage, properly performed, is a valuable diagnostic tool for these patients. A specific organ injury diagnosis is not
necessary-only
the
finding of an acute abdominal injury. Management of blunt and penetrating trauma to the abdomen includes:
1) Re-establishing vital functions and optimizing oxygenation and tissue perfusion.
2) Delineation the injury mechanism.
3) Maintaining a high index of suspicion related to occult vascular and retroperitoneal injuries.
4) Repeating a meticulous physical examination, assessing for changes.
5) Selecting special diagnostic maneuvers as needed, performed with a minimal loss of time.
6) Early recognition for surgical intervention and prompt celiotomy.
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KEYWORD
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