Surgical Management of Abdominal Trauma

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What is a critical indication for laparotomy in a stable patient?

Tenderness to percussion on examination

History of evisceration (correct)

Absence of bowel sounds

Presence of free fluid in the abdomen

What is the primary goal of Selective Non-Operative Management (SNOM) in patients with abdominal trauma?

To promote early oral feeding

To achieve immediate surgical intervention

To provide pain management with antibiotics

To monitor the patient for clinical deterioration (correct)

What is the significance of blood per rectum or per os in a patient with abdominal trauma?

It indicates a high risk of bleeding from the spleen

It is a normal finding in abdominal trauma

It requires immediate surgical intervention

It suggests a possible bowel injury (correct)

What is the typical frequency of clinical evaluation and observation in a patient undergoing SNOM?

Every 4 hours Signup and view all the answers

What is the criteria for discharging a patient home after SNOM?

The patient remains in a good clinical condition and the abdomen remains quiescent for 24 hours Signup and view all the answers

What is the approximate miss rate of SNOM in patients with abdominal trauma?

1% Signup and view all the answers

What is the primary focus of selective non-operative management for blunt trauma?

Bleeding or late bowel perforation Signup and view all the answers

What should be done if the patient remains stable after resuscitation and evaluation, and does not have an acute abdomen?

FAST/DPL should be done as a screening test Signup and view all the answers

What is the purpose of a lateral shoot through x-ray in a supine patient?

To check for free air in the chest Signup and view all the answers

What is the typical duration of hospital stay for patients with contused small bowel?

4-5 days Signup and view all the answers

What type of injury is typically shown on a contrast CT scan?

Solid organ injury with bleeding Signup and view all the answers

What is the primary goal of treatment in a patient with a positive FAST result?

To stop the bleeding Signup and view all the answers

What is the primary concern when lifting an eviscerated bowel?

Causing further mesenteric ischemia Signup and view all the answers

What is the recommended pre-hospital management for evisceration?

Place non-adherent wet dressings over the abdomen and transfer to hospital Signup and view all the answers

What is the most common site of injury in direct blunt abdominal trauma?

Mid-jejunal area on the anti-mesenteric side Signup and view all the answers

What is the primary goal of initial management in evisceration?

To prevent further bowel ischemia Signup and view all the answers

What is the typical indication for laparotomy in patients with evisceration?

To exclude other injuries and definitively repair the bowel Signup and view all the answers

What type of trauma is more likely to injure the solid organs such as the liver and spleen?

Blunt trauma Signup and view all the answers