Blunt Abdominal Trauma Differential Diagnoses

  • Author: John Udeani, MD, FAAEM; Chief Editor: John Geibel, MD, DSc, MA   more...
 
Updated: Oct 25, 2011
 
 

Diagnostic Considerations

Identification of intra-abdominal injuries can be challenging. Common pitfalls in diagnosis include the following:

  • Failure to suspect intra-abdominal injury from appropriate mechanisms
  • Failure to evaluate abdominal/flank/costal margin pain after blunt abdominal injury
  • Failure to obtain timely surgical consultation and operative intervention
  • Failure to recognize intra-abdominal hemorrhage and delay operation for additional diagnostic testing in the face of hemodynamic compromise

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

John Udeani, MD, FAAEM  Assistant Professor, Department of Emergency Medicine, Charles Drew University of Medicine and Science, University of California, Los Angeles, David Geffen School of Medicine

John Udeani, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Joseph A Salomone III, MD  Associate Professor and Attending Staff, Truman Medical Centers, University of Missouri-Kansas City School of Medicine; EMS Medical Director, Kansas City, Missouri

Joseph A Salomone III, MD is a member of the following medical societies: American Academy of Emergency Medicine, National Association of EMS Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Samuel M Keim, MD  Associate Professor, Department of Emergency Medicine, University of Arizona College of Medicine

Samuel M Keim, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Public Health Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Eric L Legome, MD  Chief, Department of Emergency Medicine, Kings County Hospital Center; Associate Professor, Department of Emergency Medicine, New York Medical College

Eric L Legome, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Jeffrey P Salomone, MD, FACS, NREMT-P  Associate Professor of Surgery, Emory University School of Medicine; Deputy Chief of Surgery, Grady Memorial Hospital

Jeffrey P Salomone, MD, FACS, NREMT-P is a member of the following medical societies: American College of Surgeons, American Medical Association, Medical Association of Georgia, National Association of EMS Physicians, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Ernest Dunn, MD  Program Director, Surgery Residency, Department of Surgery, Methodist Health System, Dallas

Ernest Dunn, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, Association for Academic Surgery, Society of Critical Care Medicine, and Texas Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Robert L Sheridan, MD  Assistant Chief of Staff, Chief of Burn Surgery, Shriners Burns Hospital; Associate Professor of Surgery, Department of Surgery, Division of Trauma and Burns, Massachusetts General Hospital and Harvard Medical School

Robert L Sheridan, MD is a member of the following medical societies: American Academy of Pediatrics, American Association for the Surgery of Trauma, American Burn Association, and American College of Surgeons

Disclosure: Nothing to disclose.

Rick Kulkarni, MD  Attending Physician, Department of Emergency Medicine, Cambridge Health Alliance, Division of Emergency Medicine, Harvard Medical School

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

Chief Editor

John Geibel, MD, DSc, MA  Vice Chair and Professor, Department of Surgery, Section of Gastrointestinal Medicine, and Department of Cellular and Molecular Physiology, Yale University School of Medicine; Director, Surgical Research, Department of Surgery, Yale-New Haven Hospital

John Geibel, MD, DSc, MA is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, and Society for Surgery of the Alimentary Tract

Disclosure: AMGEN Royalty Consulting; ARdelyx Ownership interest Board membership

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Sidney R Steinberg, MD, FACS,to the development and writing of a source article.

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Blunt abdominal trauma. Normal Morison pouch (ie, no free fluid).
Blunt abdominal trauma. Free fluid in Morison pouch
Blunt abdominal trauma. Normal splenorenal recess.
Blunt abdominal trauma. Free fluid in splenorenal recess.
Blunt abdominal trauma with splenic injury and hemoperitoneum.
Blunt abdominal trauma with liver laceration.
Blunt abdominal trauma. Right kidney injury with blood in perirenal space. Injury resulted from high-speed motor vehicle collision
Ultrasound image of right flank. Clear hypoechoic stripe exists between right kidney and liver in Morison pouch.
Ultrasound image of left flank in same patient, with thin hypoechoic stripe above spleen and wider hypoechoic stripe in splenorenal recess.
 
 
 
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