Abdominal Truama- Surgical Diseases- 4th Year PMU

Question	Answer
What is the definition of "penetrating abdominal trauma"?	Penetrating abdominal trauma is an injury that occurs when an object pierces the parietal peritoneum and enters into peritoneal cavity. Penetrating trauma to the abdomen can result in laceration of solid organs and perforation of hollow organs, which must be discovered and repaired at the time of laparotomy.
What is the definition of ''blunt abdominal trauma"?	Blunt abdominal trauma (non- penetrating) is a trauma in which traumatic object does not pierce the parietal peritoneum and the skin is usually no broken. Blunt trauma can result in the laceration of solid organs usually causing bleeding, which in its most severe form manifests as hemorrhagic shock or as visceral perforation of the gastrointestinal tract.
What is the management of blunt abdominal trauma patients who are unstable and have intraabdominal fluid identified on focused abdominal sonography in trauma {FAST)?	They require an emergent laparotomy to manage bleeding.
Which method of evaluation is used in patients with blunt abdominal trauma for whom mental status or concomitant injuries- compromise the abdominal examination and focused abdominal sonography in trauma is unavailable?	In patients for whom mental status or concominant injuries compromise the abdominal examination, diagnostic peritoneal lavage may provide valuable information
What is the management in patients sustaining anterior abdominal gunshot wounds?	Because of the high rate of intraabdominal injury, patients sustaining anterior abdominal gunshot wounds are frequently transferred quickly to the operating room for laparotomy.
What is the management in patients with abdominal stab wounds with hemodynamic instability, peritonitis, or evisceration?	Patients with abdominal stab wounds with hemodynamic instability, peritonitis, or evisceration require immediate laparotomy with repair of injuries.
What is the general principle of emergent laparotomy in abdominal trauma patients?	Abdominal trauma patients who require emergent laparotomy should undergo a systematic exploration so that all areas of the abdomen are assessed and injuries are not missed.
Which is the standard technique of opening the abdomen in emergent laparotomy?	As a standard technique, the abdomen is opened from the xiphoid process to pubic symphysis to provide adequate exposure of all abdominal structures.
Which solid abdominal organ is most commonly injured in blunt abdominal trauma?	The spleen is listed the first most commonly injured solid viscus in the abdomen despite its relatively protected site.
Which are the most common causes for spleen injuries?	Road traffic accidents and sports injuries.
What is the definition of "delayed" rupture of the spleen?	''Delayed" rupture of the spleen occurs when the clinical signs develop alter a delay of at least 48 h from the initial injury. It is generally believed to result from tearing of the capsule by the expansion of a sub-capsular haematoma.
What is the definition of "Kehr's sign"?	Pain in the tip of the left shoulder due to the irritation of the under surface of the diaphragm by blood into the peritoneal cavity (leak by injured spleen) stimulates the phrenic nerve (C4 dermatome).
Why liver is a frequently involved organ penetrating and blunt abdominal trauma?	The liver's size and its anatomic location, directly under the right costal margin, make it the most susceptible organ for injury in blunt trauma and a frequently involved organ in penetrating trauma.
What is the clinical presentation intra-abdominal haemorrhage in conscious patients?	The usual presentation of intra-abdominal haemorrhage is abdominal pain, tenderness, guarding and rigidity
What is the definition of "haemobilia"?	Haemobilia is gastrointestinal haemorrhage caused by bleeding into the biliary tree - sign of extensive liver haematoma.
In which abdominal traumas (blunt or penetrating) stomach is most commonly affected?	Gastric injuries most commonly occur after penetrating abdominal trauma. Penetrating injuries are frequently full-thickness perforations resulting in the spillage of gastric contents
What is the clinical presentation of gastric injuries with full thickness perforations of the stomach?	Gastric injuries with full thickness perforations of the stomach are presented by the presence of peritonitis - due to the peritoneal irritation from the intraperitoneal leakage of the low pH content of the stomach.
Why physical examination findings in duodenal injuries may be limited?	Because of the retroperitoneal location of a significant portion of the duodenum, physical examination findings in duodenal injuries may be limited.
Why injuries of the duodenum are frequently associated with pancreatic injuries?	Because of their adjacent location, injuries to the duodenum are frequently associated with pancreatic injuries
Pancreatic injuries are serious problem, in abdominal trauma, resulting in high mortality	High mortality rates in pancreatic injuries can frequently be attributed to delays in their diagnosis and treatment. Because of the caustic nature of pancreatic enzymes, delays in managing pancreatic injuries result in massive systemic inflammation, with subsequent poor outcomes.

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Abdominal Truama- Surgical Diseases- 4th Year PMU

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