LESSON 6
ABDOMINAL TRAUMA
6-1.
INTRODUCTION
Injuries to the abdomen are of concern to individuals who are involved with acute
medical care. Many penetrating abdominal wounds are seen in combat. Surgical
treatment is often necessary. Prompt initial therapy is the key to survival.
6-2.
CAUSES AND MECHANISMS OF ABDOMINAL INJURIES
Automobile accidents, gunshot wounds, and stabbings to the abdomen are the
most common causes of abdominal trauma. Automobile accidents are a common
cause of abdominal injuries and trauma. The reason is that the seat belt is normally
fastened across the abdomen resulting in seat belt trauma. Gunshot wounds to the
abdomen also cause abdominal trauma. In the civilian sector, such wounds usually
occur at low speed. In the military, gunshot wounds usually occur with high speed
causing tissue to be destroyed. Gunshot wounds are more common in the military than
stab wounds. In the civilian community, the reverse is true with stabbings to the
abdomen being more common then gunshot wounds to the abdomen. Stab wounds
can be very deceiving in that they may be more serious than they look. A small hole
from an ice pick or screwdriver can hide a rupture of the spleen, for example.
a. Most Commonly Ruptured Organs. The spleen, the liver, the intestines,
and the kidneys are the most commonly ruptured organs. The spleen is the organ
which ruptures most frequently in blunt trauma. The liver ruptures frequently in
penetrating trauma despite the protection of the rib cage. The size, weight, and location
of the liver makes this organ highly susceptible to injuries. Injury to the intestines may
be difficult to diagnose. Such injury sometimes goes undetected for days. The most
common sign of intestinal injury is local tenderness. The casualty may eat and have
normal bowel movements for a week before fever or infection begins. The kidneys
bruise easily.
b. Hemorrhaging Vessels. Two major vessels are likely to hemorrhage if there
is abdominal trauma. These vessels are the abdominal aorta and the inferior vena
cava. An individual with abdominal hemorrhaging, who vomits and strains will increase
the hemorrhaging.
NOTE:
Body cavities are spaces in the body containing internal organs. The
abdominal cavity contains the stomach, spleen, liver, gallbladder, pancreas,
small intestine, most of the large intestine, the kidneys, and the ureters.
MD0581
6-2