Abdominal Trauma
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This may present as a blunt or penetrating injury to the abdomen.
Cause
- Road traffic accidents
- Gunshots
- Violence
- Trauma to the abdomen
Symptoms
- Pain
- Vomiting
- Distended abdomen
Signs
- Distended abdomen
- Tenderness and rebound tenderness
- Guarding
- Tympanitic percussion sound
- Reduced or absent bowel sounds
- Point of penetration
Investigations
- Plain and erect abdominal X-ray
- Abdominal CT scan
- BUE and Creatinine
- Abdominal ultrasound scan
- Diagnostic peritoneal lavage
- Blood grouping and cross matching
TreatmentTreatment Objectives
- To correct fuid and electrolyte imbalance
- To decompress bowel
- To repair damaged viscus
- To prevent infection
- To relieve pain
Non-pharmacological treatment
- Insert an NG tube
- Surgical repair of damaged viscus if necessary
Pharmacological treatment
For infection control
1st Line Treatment
Evidence Rating: [A]
- Cefuroxime, IV,
Adults
750 mg 8 hourly for 7-14 days
Children
> 3 months 25 mg/kg body weight 12 hourly for 7-14 days
And
- Metronidazole, IV,
Adults
500 mg 8 hourly for 7-14 days
Children
7.5 mg/kg 8 hourly for 7-14 days
Referral Criteria
Refer all cases to a general surgeon.