(c) Epigastric tenderness and/or rigidity. Rigidity is a critical sign when
blunt trauma is the cause; surgery is required.
(d) Fever.
(e) High intestinal obstruction.
d. Penetrating Injuries. These injuries have both solid organ and hollow organ
involvement. (This includes eviscerations, injuries in which the intestine protrudes
through the intestinal wall.) In solid organ involvement, the liver may hemorrhage into
the abdomen and lead to hypovolemic shock. The spleen may rupture which usually
means that the spleen must be surgically removed. The kidneys may develop
hematuria (blood in the urine). In the case of hollow organ involvement (intestinal
injuries), chemical and bacterial peritonitis (inflammation of the intestine linings) may
occur. Penetrating stomach wounds can cause bloody nasogastric aspirate. Blood
found on rectal examination may be due to lower colon wounds.
NOTE:
Subcutaneous emphysema (the presence of air or gas in the tissues under
the top layer of skin is possible in the abdominal wall if there are ruptures in
hollow organs.
6-5.
TREATMENT FOR ABDOMINAL INJURIES
Begin treating for abdominal injuries immediately.
a. First, Apply Emergency Medical Treatment to Sustain Life. Check the
casualty's airway, breathing, and circulation.
(1) Check the airway and at the same time assess the casualty for any
cervical spine injuries. To determine whether the casualty is breathing, follow this
procedure. Place your ear over the casualty's mouth and nose and look towards the
casualty's chest. Your ear should be touching the casualty's nose. Look at the
casualty's chest. If he is breathing, you should be able to see his chest rise and fall.
Listen for the sound of breathing (air being inhaled and exhaled). Feel for the flow of air
on the side of your face; the air flow is caused by the casualty exhaling. If you suspect
that the casualty may have a cervical spine injury, DO NOT move the casualty's head
or neck.
MD0581
6-8