b. Signs/Symptoms of Abdominal Injuries. Included are the following:
(1)
Localized or generalized pain.
(2)
Blood in emesis (vomit).
(3) Abdomen rigid when palpated. This critical sign, rigidity, is caused by
muscle spasms in the abdominal body wall.
(4)
Pain caused by light pressure (tenderness).
(5) Signs of shock when there is no apparent hemorrhage. There is often
internal bleeding which was caused by the blow of a blunt object.
(6)
Distention (swelling), a late sign.
(7)
Pain referred up either shoulder.
(8)
Extravasation (escape of fluid) of urine or blood under the skin.
(9)
Jaundice.
(10) Unusual masses (hernia). You may feel a tumor or intestinal obstruction
if the mass is large. The exact location should be recorded for the doctor.
(11) Lack of bowel sounds. By itself, this is not significant.
NOTE:
Abdominal tenderness, guarding, and rigidity, on palpation are probably the
most frequent and reliable findings of abdominal injury.
c. Significant Findings of Abdominal Injury Evaluation. If there are missile
wounds in the abdominal walls, note the position of the casualty at the time of impact.
This will help you determine the extent of damage due to missile trajectory. High
velocity missiles can cause extensive internal damage to the human body. Bullets can
tumble around organs and bounce off bones. Wounds of the chest or buttocks can also
cause abdominal injury. The soldier may experience diaphragmatic rupture, the
diaphragm reaching just below the nipples. If the casualty experiences rectal bleeding,
there may be damage to the colon.
6-4.
NONPENETRATING AND PENETRATING ABDOMINAL INJURIES
a. Classification of Abdominal Injuries. Abdominal injuries can be classified
as either penetrating wounds (the skin is penetrated) or nonpenetrating blunt wounds
(the skin is not penetrated).
MD0581
6-6
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