Abdominal trauma can be blunt or penetrating. Blunt injuries occur when there is no break in the skin; they often occur as multiple injuries. In blunt injuries, the spleen and liver are the most commonly injured organs. Injury occurs from compression, concussive forces that cause tears and hematomas to the solid organs such as the liver, and deceleration forces. These forces can also cause hollow organs such as the small intestines to deform; if the intraluminal pressure of hollow organs increases as they deform, the organ may rupture. Deceleration forces such as those that occur from a sudden stop in a car or truck may also cause stretching and tears along ligaments that support or connect organs, resulting in bleeding and organ damage. Examples of deceleration injuries include hepatic tears along the legamentum teres (round ligament that is the fibrous remnant of the left umbilical vein of the fetus, originates at the umbilicus, and may attach to the inferior margin of the liver), damage to the renal artery intima, and mesenteric tears of the bowel.

Penetrating injuries are those associated with foreign bodies set into motion. The foreign object penetrates the organ and dissipates energy into the organ and surrounding areas. The most commonly involved abdominal organs with penetrating trauma include the intestines, liver, and spleen. Complications following abdominal trauma include profuse bleeding from aortic dissection or other vascular structures, hemorrhagic shock, peritonitis, abscess formation, septic shock, paralytic ileus, ischemic bowel syndrome, acute renal failure, liver failure, adult respiratory distress syndrome, disseminated intravascular coagulation, and death.

0 0

Post a comment