18 Questions
Which organ is most commonly involved in blunt trauma laparotomy for patients with GSW?
Small bowel
What mechanism of injury is typically associated with small bowel injuries?
Sudden deceleration
Which method is considered superior to FAST or CT for diagnosing small bowel injuries?
DPL
What is a common sign associated with small bowel injuries?
Seat belt sign
What imaging modality is not particularly sensitive in the immediate post-injury period for major pancreatic trauma?
CT with PO/IV contrast
Which organ is commonly compressed against the vertebral column in cases of direct epigastric blow?
Pancreas
Which sign indicates peritoneal bleeding, often from pancreatic hemorrhage?
Cullen sign
In a trauma setting, left shoulder pain while supine can be caused by:
Kehr sign
What physical exam finding points to splenic injury with blood accumulating in the spleen?
Balance sign
What physical exam finding is associated with retroperitoneal bleeding of the pancreas, kidney, or pelvic fracture?
Grey-Turner sign
Which area shows bluish discoloration in the Grey-Turner sign?
Lower flanks and lower back
What does the Cullen sign indicate in terms of hemorrhage?
Peritoneal bleeding
Which area of the abdomen includes organs such as the liver, spleen, stomach, and transverse colon?
Intra thoracic abdomen
Which part of the abdomen contains structures like the small bowel, ascending colon, descending colon, and sigmoid colon?
True abdomen
Where in the abdomen would you find the rectum, bladder, iliac vessels, and internal reproductive organs in women?
Pelvic abdomen
Which area of the abdomen is posterior to the peritoneal lining and contains structures like the abdominal aorta, IVC, most of the duodenum, pancreas, kidneys, and ureters?
Retroperitoneal abdomen
Which mechanism of injury involves differential movements of fixed and non-fixed structures leading to lacerations at sites of supporting ligaments?
Deceleration injuries
Which mechanism of injury can cause entrapment injuries to abdominal viscera resulting in deformation and rupture of solid or hollow organs?
Compression injuries
Study Notes
Blunt Trauma Laparotomy
- Spleen is the organ most commonly involved in blunt trauma laparotomy for patients with gunshot wounds (GSW).
Small Bowel Injuries
- Typically associated with deceleration mechanism of injury, which involves differential movements of fixed and non-fixed structures leading to lacerations at sites of supporting ligaments.
- Diagnosed via diagnostic peritoneal aspiration (DPA) or diagnostic laparoscopy, which are considered superior to FAST or CT.
- Common sign associated with small bowel injuries is abdominal tenderness.
Pancreatic Trauma
- CT scan is not particularly sensitive in the immediate post-injury period for major pancreatic trauma.
- The duodenum is commonly compressed against the vertebral column in cases of direct epigastric blow.
- Grey-Turner sign, characterized by bluish discoloration of the flank, indicates peritoneal bleeding, often from pancreatic hemorrhage.
Physical Exam Findings
- Left upper quadrant tenderness and Kehr's sign (left shoulder pain while supine) can indicate splenic injury with blood accumulating in the spleen.
- Upper abdominal tenderness and guarding can indicate retroperitoneal bleeding of the pancreas, kidney, or pelvic fracture.
Abdominal Regions
- The left upper quadrant of the abdomen includes organs such as the spleen, stomach, and transverse colon.
- The peritoneal space contains structures like the small bowel, ascending colon, descending colon, and sigmoid colon.
- The pelvis contains structures like the rectum, bladder, iliac vessels, and internal reproductive organs in women.
- The retroperitoneal space is posterior to the peritoneal lining and contains structures like the abdominal aorta, IVC, most of the duodenum, pancreas, kidneys, and ureters.
Test your knowledge on the etiology of abdominal trauma including penetrating and blunt injuries, as well as anatomical considerations of the abdomen. Topics include stab wounds, gun shot injuries, road traffic accidents, and different areas of the abdomen. Dr. Sherko Abbas Nadir's expertise in general and laparoscopic surgery is highlighted in this quiz.
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