injuries poisoning
Overview of Abdominal Trauma
Pathophysiology of Abdominal Trauma
Blunt or penetrating trauma may lacerate or rupture intra-abdominal structures. Blunt injury may alternatively cause only a hematoma in a solid organ or the wall of a hollow viscus. Associated injuries hemorrhage immediately. Hemorrhage due to low-grade solid organ injury, minor vascular laceration, or hollow viscus laceration is often low-volume, with minimal physiologic consequences. More serious injuries may cause massive hemorrhage with Laceration or rupture of a hollow viscus allows gastric, intestinal, or bladder contents to enter the peritoneal cavity, causing peritonitis. Delayed consequences of abdominal injury include Hematoma rupture Intra-abdominal abscess Bowel obstruction or ileus Biliary leakage and/or biloma Abdominal compartment syndrome Abscess, bowel obstruction, abdominal compartment syndrome, and delayed incisional hernia also can be complications of treatment. typically resolve spontaneously over several days to months, depending on the size and location. Splenic Injury and, less often, Intra-Abdominal Abscesses None Intestinal Obstruction None Complications None Abdominal compartment syndrome is analogous to Compartment Syndrome after orthopedic injury. In abdominal compartment syndrome, mesenteric and intestinal capillary leakage (eg, due to Kidneys (causing renal insufficiency) Lungs (elevated abdominal pressure can interfere with respiration, causing hypoxemia and hypercarbia) Cardiovascular system (elevated abdominal pressure decreases venous return from the lower extremities, causing hypotension) Central nervous system (intracranial pressure increases, possibly due to rise in central venous pressure preventing adequate venous drainage from brain, decreasing cerebral perfusion, which can worsen intracranial injuries) Abdominal compartment syndrome typically occurs in conditions in which there is both vascular leak and high-volume fluid resuscitation (usually > 10 L). Thus, it often develops after laparotomy for severe abdominal injury accompanied by shock but may occur in conditions not primarily affecting the abdomen, such as severe Burns , 