Visceral injuries are injuries to all internal organs. Abdominal injuriesAbdominal trauma is an injury to the abdomen. Signs and symptoms include abdominal pain, tenderness, rigidity, and bruising of the external abdomen. Complications may include blood loss and infection.https://en.wikipedia.org › wiki › Abdominal_traumathoracic injuriesA chest injury, also known as chest trauma, is any form of physical injury to the chest including the ribs, heart and lungs. Chest injuries account for 25% of all deaths from traumatic injury.https://en.wikipedia.org › wiki › Chest_injury
A direct blow from blunt trauma can lead to solid organ rupture and visceral damage causing haemorrhage, contamination with the visceral contents, peritonitis and associated pelvic injuries. The most common organs injured are the spleen, liver and small bowel.
The liver is the most commonly injured organ in blunt abdominal trauma and the second most commonly injured organ in penetrating abdominal trauma [3-6]. The liver is a highly vascular organ located in the right upper quadrant (figure 1) of the abdomen and is susceptible to injury from traumatic mechanisms.
Early indications of abdominal trauma include nausea, vomiting, blood in the urine, and fever. The injury may present with abdominal pain, tenderness, distension, or rigidity to the touch, and bowel sounds may be diminished or absent.
The spleen is the organ damaged most commonly, followed by the liver and a hollow viscus (typically the small intestine). Penetrating injuries may or may not penetrate the peritoneum and, even if they do, they may not cause organ injury.
The intestines were most commonly impacted by penetrating trauma (70.1% of cases), followed by the liver and spleen (19.4% and 17.9%, respectively). The most common mode of injury in penetrating trauma cases was gunshot (85%) and stab wounds (15%).
The most common abdominal injuries are blunt and penetrating, and commonly injured organs are the spleen, bowels, stomach, and liver, with the least-frequently injured organs being the diaphragm and kidneys [14].
Abdominal ultrasound can be used to look for organ injury and free intra-abdominal fluid, which after trauma is assumed to be blood or gastrointestinal content, and provides indirect evidence of injury.
Typically, patients may be discharged home after 2 to 3 days. They are instructed to restrict activity for a minimum of 6 to 8 weeks. It is not clear which asymptomatic patients require an imaging study before resuming full activity, especially when heavy lifting, contact sports, or torso trauma are likely to occur.
The most commonly injured organs are the spleen, liver, retroperitoneum, small bowel, kidneys (see the image below), bladder, colorectum, diaphragm, and pancreas. Men tend to be affected slightly more often than women. Blunt abdominal trauma. Right kidney injury with blood in perirenal space.
The urinary bladder is considered as a hollow muscular organ that does not face injury during a vehicle mishap. The urinary bladder is located within the pelvis bone; the pelvic cavity protects the bladder from external forces on the body of a living organism.
Blunt force trauma can often lead to bruising and blood clots. Bruising occurs when the blood vessels on the surface of the soft tissue of skin are broken, typically resulting in a temporary discoloration of the skin.
The manifestations of blunt trauma differ depending on the force and the nature of the impact. The three recognized lesions are contusion, abrasion, and laceration.
Visceral pain, the pain we feel when our internal organs are inflamed, diseased, damaged or injured, is by far the most common type of pain. All of us will have experienced pain emanating from our internal organs, from the mild discomfort of indigestion to the agony of renal colic.
Visceral pain is often associated with marked autonomic phenomena, including pallor, profuse sweating, nausea, GI disturbances and changes in body temperature, blood pressure and heart rate (15).
Besides pain, the patient may present with bleeding per rectum, unstable vital signs, and the presence of peritonitis. The physical exam may reveal marks from a lap belt, ecchymosis, abdominal distention, absent bowel sounds and tenderness to palpation.
[11] reported motor vehicle crashes (MVCs), fall from height and assaults to be the most common causes of blunt abdominal trauma. The penetrating trauma is mainly caused by gunshot, stab, and other objects that enter the peritoneal cavity.
Assist the patient to lie down in a position of greatest comfort, usually on the back or on the uninjured side, with both knees drawn up for relief of pain and spasm. Loosen any tight clothing, especially at waist and neck. Support the patient with pillows and blankets for comfort, as needed. Give frequent reassurance.
Signs and Symptoms may include:
Blood stained vomit or urine. Breathing noises. Tenderness Bruising, and/or swelling. Protruding Intestines.
The spleen and liver are the two most commonly injured organs. Hollow organs are less likely to be injured. Penetrating injuries occur when an object breaks the skin (for example, as a result of a gunshot or a stabbing).
The liver and spleen organs are most vulnerable; therefore, it may be beneficial to apply concerted efforts to focus on injury biomechanics research and prioritization activities in these areas of the abdomen.
Conclusion. Laparoscopy is found to be a good alternative to laparotomy, as it is considered to be a reliable and safe method in hemodynamically stable patients with blunt abdominal trauma. It can be used to reduce the rate of laparotomy with lower morbidity and mortality rates.