Abdominal Trauma and Pain

Abstract

Trauma is the most common cause of death in the young population, predominantly males. Abdominal trauma is a leading source of occult bleeding which is the second cause of early-phase deaths following major head injury. Uncontrollable bleeding constitutes the most common cause of preventable deaths especially if the management of shock is delayed. Penetrating trauma leads to significant morbidity and mortality, nonetheless, diagnosed more easily with its remarkable presentation. The main goal in the evaluation of the abdomen in the acute setting is to uncover (i.e., not to overlook) the injuries requiring surgery without delay, rather than to diagnose specific injuries in detail. Signs and symptoms of progressing shock states vary from patient to patient, and sometimes very subtle changes can herald impending doom. The clinician should be proactive in detecting the injuries, using both evaluation findings and bedside ultrasound together with other advanced imaging techniques when necessary, keeping in mind that occult injuries can evolve in time insidiously. Ongoing intraabdominal bleeding is an ominous finding which precedes advanced hemorrhagic shock and needs to be sought for carefully in patients with trauma.