b. Nonpenetrating (Blunt) Injuries. These injuries are caused by a heavy blow
pushing the contents of the abdomen up against the spine. Blunt injuries damage the
abdominal body wall and are equally tender whether muscles are tight or relaxed. If the
abdominal cavity is injured, it will be more tender when the abdominal muscles are
relaxed. Blunt trauma is often overlooked when it is associated with other injuries.
c. Complications Associated with Nonpenetrating (Blunt) Injuries.
(1) Ruptured spleen. The organ most frequently injured by blunt trauma is
the spleen. Signs and symptoms include:
(a) A history of trauma.
Pain in the left upper quadrant (LUQ).
Referred pain in the top left shoulder.
(d) Hypovolemia (abnormally decreased amount of blood circulating in
Lacerated liver. Signs and symptoms of this condition include:
(a) Pain and tenderness in the right upper quadrant (RUQ).
(b) Jaundice (a yellowing of the skin due to disturbed functioning of the
Referred pain in the right top shoulder due to nerves that service
(d) Hypovolemia progressing to shock since the liver is an organ with
many blood vessels.
(3) Peritonitis. This condition is inflammation of the peritoneum. Leakage
from a ruptured gallbladder may be a sign that the casualty has peritonitis.
(4) Duodenum and pancreas. An injured duodenum and pancreas are
usually associated with another organ's involvement with injury. Look for the following:
(a) Epigastric pain.
(b) Hypovolemia progressing to shock.