Overview
What are the challenges to correctly diagnosing blunt abdominal trauma?
What are the advantages of CT scanning in the evaluation of blunt abdominal trauma?
What are the signs and symptom of blunt abdominal trauma in an alert patient?
Which injury patterns suggest an intra-abdominal trauma?
What is included in the evaluation of a patient with blunt abdominal trauma?
When is diagnostic peritoneal lavage (DPL) indicated in the workup of blunt abdominal trauma?
How is blunt abdominal trauma treated?
When is laparotomy indicated in the treatment of blunt abdominal injury?
Which nonoperative therapies are used in the treatment of blunt abdominal trauma?
What is the pathophysiology of blunt abdominal trauma?
What causes blunt abdominal trauma?
What is blunt abdominal trauma?
What is the anatomy of the abdomen relevant to blunt abdominal trauma?
What is the US prevalence of blunt abdominal trauma?
What is the global prevalence of blunt abdominal trauma?
Which age groups have the highest incidence of blunt abdominal trauma?
What are the sexual predilections of blunt abdominal trauma?
What is the prognosis of blunt abdominal trauma?
What is included in patient education for the prevention of blunt abdominal trauma?
Presentation
Who may provide initial history in a blunt abdominal trauma?
What is the focus of clinical history in motor vehicle accident-caused blunt abdominal trauma?
What are the elements of the clinical history for blunt abdominal trauma?
How is the mnemonic AMPLE used to gather history in blunt abdominal trauma?
What does out-of-hospital hypotension suggest in blunt abdominal trauma?
What precautions should be taken by all staff caring for a patient with blunt abdominal trauma?
What is included in the in the abdominal exam of patients with blunt trauma?
How does the physical exam for blunt abdominal trauma differ between pediatric and adult patients?
Why is a tertiary physical exam performed in patients with blunt abdominal trauma?
What are the possible complications of blunt abdominal trauma?
DDX
What are the common pitfalls in the diagnosis of blunt abdominal trauma?
What are the differential diagnoses for Blunt Abdominal Trauma?
Workup
What is the role of lab tests in the workup of blunt abdominal trauma?
What is the role of CBC in the workup of blunt abdominal trauma?
What is the role of serum electrolyte measurements in the workup of blunt abdominal trauma?
What is the role of liver function tests in the workup of blunt abdominal trauma?
What is the role of serum amylase or lipase measurements in the workup of blunt abdominal trauma?
What is the role of a coagulation profile in the workup of blunt abdominal trauma?
What is the role of arterial blood gas measurements in the workup of blunt abdominal trauma?
What is the role of drug and alcohol screening in the workup of blunt abdominal trauma?
What is the role of urine studies in the workup of blunt abdominal trauma?
What is the role of plain radiography in the workup of blunt abdominal trauma?
What is the role of ultrasonography in the workup of blunt abdominal trauma?
What is the role of CT in the workup of blunt abdominal trauma?
What is the prediction rule of CT scanning for pediatric blunt abdominal trauma?
What is the role of diagnostic laparoscopy in the workup of blunt abdominal trauma?
What is the role of diagnostic peritoneal lavage (DPL) in the workup of blunt abdominal trauma?
How is diagnostic peritoneal lavage (DPL) performed in the workup of blunt abdominal trauma?
Treatment
When does the treatment of blunt abdominal trauma begin?
When are surgical interventions indicated in the treatment of blunt abdominal injury?
What is included in the prehospital care of blunt abdominal trauma?
How is blunt abdominal trauma treated in the emergency department (ED)?
What is the role of nonoperative treatment (NOM) in the treatment of blunt abdominal trauma?
What is the role of resuscitative thoracotomy in the treatment of blunt abdominal trauma?
What is the role of laparotomy in the treatment of blunt abdominal trauma?
Which specialist consultations are beneficial to patients with blunt abdominal trauma?
When is patient transfer considered for the treatment of blunt abdominal trauma?
What are the signs and symptoms of undiagnosed blunt abdominal trauma?
Medications
What is the role of medication for treatment of blunt abdominal trauma?
Which medications in the drug class Antibiotics are used in the treatment of Blunt Abdominal Trauma?
Which medications in the drug class Analgesics are used in the treatment of Blunt Abdominal Trauma?
-
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.
-
Surgical cricothyroidotomy Seldinger. Video courtesy of Therese Canares, MD, and Jonathan Valente, MD, Rhode Island Hospital, Brown University.