Digestion

Signs and Symptoms of Abdominal Trauma

Abdominal trauma or accidental injuries to the abdomen are very common. Abdominal injuries are of two types, blunt and penetrating. These two types of injury have very high rates of morbidity and mortality. The reason behind this is that, the symptoms could be misleading and difficult to identify and associate with injury to the abdomen.

In this article, we are going to focus on the damages caused by trauma or accidental injury to the organs of the digestive tract. Vehicle accidents result in the blunt type of injury to the abdomen, 75% of the times. The mortality rate from this type of injury is about 8.5%. Wounds from gun shots and stabs cause about 95% of the penetrating abdominal injuries. This particular type of trauma can have a higher mortality rate as well as a higher morbidity rate as compared to blunt injuries. The severity is more if the wound was caused by a sharp penetrating object. Even if the bleeding is brought under control and the abdominal organs are stabilized, the risks of infection and intra abdominal abscesses are significantly increased.

Effect of Abdominal Trauma on the Digestive Organs

The abdominal cavity holds the organs of the digestive tract. The digestive organs could be either solid or hollow. The liver, spleen and pancreas would classify as solid organs as they bleed when injured. The organs like the gallbladder, stomach and intestines are tubular and hollow and ensconced within a protective mucus lining. They are prone to perforation upon being injured, spilling the internal contents on to the abdominal cavity. Internal bleeding in the abdomen can result in blood getting accumulated in the abdominal cavity.

Signs and Symptoms of Abdominal Trauma

Internal injury and associated internal inflammation to the abdomen may not be evident right away as the symptoms are much generalized. Some of the early signs are as follows:

  • Nausea
  • Vomiting
  • Blood in urine
  • Fever
  • Abdominal pain
  • Abdominal tenderness
  • Abdominal distension
  • Abdominal rigidity
  • Absence of bowel sounds
  • Pneumoperitoneum or air or gas in the abdominal cavity as would be revealed by a cloud in the abdominal region in the X-ray. It is a symptom of perforation of a hollow organ.
  • Disembowelment or Evisceration. This would mean the protrusion of the gastrointestinal organs from an open wound.
  • Fractured ribs may perforate the abdominal wall and cause injuries to it.

Diagnosis

The clinical signs of injury are very often absent. It is mostly detected by radiological assessment. The three main diagnostic tests used are Computed Topography Scan, Ultrasound imaging and X-ray. CT Scans are able to detect injuries related to the hollow organs of the digestive tract with 76% accuracy.

Treatment

  • The first step in treating a trauma patient is to stabilize the individual and assure that the vital processes like breathing and circulation are uninterrupted.
  • Surgery is needed to repair organs and perforations causing spillage.
  • In case of damage, the extent of damage by penetrating organs is best assessed and necessary steps need to be taken especially to stop the bleeding.
  • Minimally invasive laparoscopic surgery is popular for resolving blood clots causing obstruction in the blood vessels. It is part of an emergency remedial measure in case of such trauma.
  • Peritonitis or infection caused by leakage and spillage from abdominal organs need to be dealt with antibiotics.
  • Depending on the intensity of the injury, intensive care treatment may be required.

However, abdominal injury is the most common cause of death due to accidental injuries.

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