Abdominal Trauma - What Should You Know About It?

Abdominal trauma refers to the condition when the abdomen is injured. Injury can either be restricted to the abdomen or coexist with severe multisystem trauma. The severity and nature of the abdominal injuries broadly vary depending upon the forces and mechanisms involved. The categorization of the injuries mostly depends upon the damaged part, such as vasculature, abdominal wall, hollow viscus including stomach, colon, bladder, small intestine and ureters, and solid organs including kidneys, spleen, liver, and pancreas. 

Generally, abdominal trauma is categorized into two types - penetrating and blunt. Penetrating injuries are mostly dramatic and obvious. Peritoneum (the membrane that lines the abdominal cavity) may not puncture due to penetrating injuries, but in case the peritoneum is injured, organ injury may not occur. This type of injury to the lower chest can cross diaphragm and disrupt abdominal structures. 

Blunt injuries may occur due to direct blow, sudden strike, the impact of an object such as the kick of the ball, vehicle crash, or fall from a great height. Mostly, the spleen organ is injured, followed by hollow viscus like small intestine and liver. It is difficult to detect the blunt abdominal injuries, especially if the individual has no external trauma signs. Abnormal blood loss can happen without any noteworthy change in abdominal appearance.

Symptoms -

Abdominal pain is a common symptom. Though the pain is usually mild, it may be easily covered by various other painful injuries such as altered sensorium and fractures. Distension in the abdomen after the trauma usually points towards a serious hemorrhage, however, distension might not be evident even in individuals with severe blood loss. Mostly, the cutaneous lesions are small, with slight bleeding, but sometimes there are large wounds together with evisceration.

Another symptom is abdominal tenderness, but it is not reliable as an injured abdominal wall can be tender. Several individuals with intra-abdominal injury have equivocal examinations if obstructed with other injuries and problems.

Treatment - 

Treatment of abdominal trauma depends upon the cause, the organ injured, and other problems that occurred due to the injury. Laparotomy is a surgical procedure used for organ repair, hemorrhage control, or both. In most of the cases, patients may undergo a single procedure to repair the injury and control the hemorrhage. Whereas, individuals with extensive intra-abdominal injuries who need lengthy surgical procedures tend to perform poorly, especially with other severe injuries or shock. 

At times, bleeding can be stopped by embolizing the bleeding channel using angiographic embolization. This can be done without surgery. But, this technique is not advisable for unstable individuals. 

Takeaway -

Abdominal trauma can be caused by a number of reasons and can affect other organs too. The treatment of abdominal injuries varies depending upon the conditions of the patient, injured organ, and other injuries if any. 

One should not avoid regular pain and tenderness in the abdominal region and should immediately consult a doctor if he/she notices any physical change in the abdominal size.