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Abdominal Vascular Injuries: Workup
Updated: Apr 13, 2007
Workup
Imaging Studies
- Hemodynamically stable patients with blunt trauma and suspected abdominal vascular injuries may benefit from abdominal CT scanning, which helps localize a hematoma and evaluate solid organ injuries.
- Stable patients with stab wounds may undergo laparoscopy to confirm peritoneal penetration. If time permits, also perform chest and pelvic radiography to exclude bleeding into the chest and pelvic fracture.
- Hemodynamically unstable patients with penetrating trauma should be transported immediately to the OR; no imaging studies are necessary. The assessment of hemodynamically unstable patients with blunt trauma to the abdomen may include FAST examination or DPL to confirm hemoperitoneum as well as portable chest radiography only if expeditious transport to the OR is not to be interrupted.
Diagnostic Procedures
- In penetrating trauma, perform an abdominal exploration on most patients with a GSW to the abdomen.
- Angiography with or without embolization may be considered in stable patients, particularly in patients with blunt trauma.
More on Abdominal Vascular Injuries |
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Workup: Abdominal Vascular Injuries |
| Treatment: Abdominal Vascular Injuries |
| Follow-up: Abdominal Vascular Injuries |
| Multimedia: Abdominal Vascular Injuries |
| References |
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References
Boffard KD, Riou B, Warren B, et al. Recombinant factor VIIa as adjunctive therapy for bleeding control in severely injured trauma patients: two parallel randomized, placebo-controlled, double-blind clinical trials. J Trauma. Jul 2005;59(1):8-15; discussion 15-8. [Medline].
Cox EF. Blunt abdominal trauma. A 5-year analysis of 870 patients requiring celiotomy. Ann Surg. Apr 1984;199(4):467-74. [Medline].
DeBakey ME. Battle injuries of the arteries in WWII: an analysis of 2,471 cases. Ann Surg. 1946;123:534.
Fabian TC. Abdominal trauma including indications for celiotomy. In: Trauma. 3rd ed. Appleton and Lange; 1996:441-59.
Feliciano DV. Abdominal vascular injury. In: Trauma. 3rd ed. Appleton and Lange; 1996:615-33.
Feliciano DV. Injuries to the great vessels of the abdomen. In: Wilmore DW, Cheung LY, Harken AH, Holcroft JW, Meakins JL, eds. Scientific American Surgery. New York: 1996, revised 1998.
Feliciano DV, Burch JM, Spjut-Patrinely V, et al. Abdominal gunshot wounds. An urban trauma center's experience with 300 consecutive patients. Ann Surg. Sep 1988;208(3):362-70. [Medline].
Jurkovich GJ, Hoyt DB, Moore FA, et al. Portal triad injuries. J Trauma. Sep 1995;39(3):426-34. [Medline].
Morris JA, Eddy VA, Rutherford EJ. The trauma celiotomy: the evolving concepts of damage control. Curr Probl Surg. Aug 1996;33(8):611-700. [Medline].
Pourmoghadam KK, Fogler RJ, Shaftan GW. Ligation: an alternative for control of exsanguination in major vascular injuries. J Trauma. Jul 1997;43(1):126-30. [Medline].
Thal ER. Operative exposure of abdominal injuries and closure of the abdomen. In: Wilmore DW, Cheung LY, Harken AH, et al, eds. Scientific American Surgery. New York: 1996, revised 1997.
Further Reading
Keywords
abdominal hemorrhage, abdominal trauma, internal injury, internal injuries, gunshot wound, gun shot wound, GSW, stab wound, penetrating wound, motor vehicle accident, MVA, blunt trauma, blunt force trauma, midline supramesocolic hemorrhage, midline supramesocolic hematoma, midline inframesocolic hemorrhage, midline inframesocolic hematoma, lateral perirenal hemorrhage, lateral perirenal hematoma, lateral pelvic hemorrhage, lateral pelvic hematoma
Workup: Abdominal Vascular Injuries