The main symptoms of abdominal organ injury
Traumatology / / August 12, 2017
Anamnesis ascertain injury mechanism, the position and state of the body at the time of injury, the direction and force of impact, the state of the abdominal wall at the time of injury (tension or muscle relaxation), the degree of filling of the gastrointestinal tract with food and liquid prior to injury and diseaseabdominal organs.Subjectively, patients complain of pain, general weakness, nausea, rarely - vomiting.Pain may be in the early hours without a specific localization, around the abdomen or with a predominance in the upper or the lower divisions.Often, the pain associated with fractures of the ribs with accompanying chest injuries (after intercostal blockade Novocain these pains disappear).Diffuse nature of pain is typical for a break intestines, mesentery, intracavitary or retroperitoneal bleeding.Localization of pain in the left or right upper quadrant radiating to the same shoulder characteristic of the damage of the liver and spleen.
important in the diagnosis have a duration, the intensit
signs of severe shock in the first 1.5-2 h after injury suggests massive internal bleeding, which is more often a source of rupture of the spleen or liver.In this case the pulse becomes thready, 130-140 beats per minute, there was a sharp (deathly) pale skin and mucous membranes, lowering the temperature of the limbs, ears, nose, forehead, there is a cold sweat.Psychomotor agitation (at low or uncertain pressure) confirms the diagnosis and is a formidable harbinger of the approaching death of the victim.Patients may complain of increasing noise in the ears, dizziness, painful thirst, lack of air.Belly have swollen, moderately tense and painful.Only emergency surgery may save the patient.
One of the reliable signs of intra-abdominal lesions is the lack of abdominal type of breathing (or, as they say, the stomach is not involved in the act of breathing).Another significant feature is the pronounced stress (rigidity) of the abdominal wall.The greater the voltage, the more likely an internal organ rupture.With the dramatic tension of the abdomen ( "as a board") intraabdominal catastrophe no doubt.The absence of noise intestinal peristalsis (auscultation) in the first hours after the injury indicates more about intra-abdominal bleeding in later periods (2-3 days) "deathly silence" of the abdomen shows diffuse peritonitis.Symptoms of peritoneal irritation (Shchetkina symptom -. Blumberg and others) are not specific for stomach injuries, but they always point to the acute irritant arising in the abdominal cavity.The combination of these symptoms with other objective and subjective data significantly improves the accuracy of diagnosis.
frequent symptom is vomiting intra-abdominal lesions in the early period is linked to stimulation of the vagus nerve in the late - with intoxication.There should always alert the symptom of "Roly-Poly" -.. The desire of the patient to return to its original position after turning over on his back, the other side, etc. The basis of this phenomenon is the sharp increase in pain from irritation of new sections of the peritoneum izlivshimsya contents of the gastrointestinal tract or blood(even small amounts).The emergence of blunting in sloping areas of the abdomen indicates the presence of fluid in the abdominal cavity.This feature becomes clear when the accumulation of about 1 liter of liquid.If blood accumulates, it must at the same time determined by objective evidence of massive blood loss.Reliability feature is enhanced if the fluid boundary is moved when changing the patient's position.
simple but highly informative diagnostic technique is bladder catheterization (especially when concomitant fractures of the pelvis).Full bladder may obscure the clinical picture of abdominal damage, lack of urine may be the cause of intra-abdominal rupture of the bladder, blood in the urine - a consequence of damage to the kidneys.
rectal digital examination can also be very informative.This is the only method of direct palpation of the peritoneum.The accumulation of blood or other fluid in the recto-vesical recess in men or in utero-rectal recess in women can be directly palpated through the rectum and thus definitively confirm the diagnosis.
- abdominal organ injuries (general information)
- spinal injuries in conjunction with liver damage and spleen
- First aid and treatment for injuries of the abdomen
- Multiple fractures of foot
- Multiple fractures of femurbone
- multiple fractures of the tibia
- multiple fractures ankle
- multiple fractures of the bones of the knee joint
- multiple fractures of the bones and the bones of one segment
- clinical picture of multiple fractures pelvis
- Combined treatment of injuries
- treatment of multiple fractures of ribs
great help in diagnosis can have X-ray examination, if the general condition of the patient allows you to turn it on its side, or give the torso upright.It can be detected in X-ray pattern abdomen shadows corresponding free fluid in the abdominal cavity, and illumination in the form of a strip, a sickle or subdiaphragmatic spaces along the side surface of the stomach (at the position on the side of the patient).
In a laboratory blood test can establish indicators decreased hemoglobin, hematocrit, red blood cell count, increasing the number of leukocytes.In the early period, these changes are not typical, but the definition of these indicators over time will no doubt be useful to clarify the diagnosis.Additionally, you can determine the mass of blood and nomograms to calculate the approximate value of blood loss.
The most reliable method for diagnosing damage to the abdominal cavity is a laparotomy.Visually define the nature and extent of intra-abdominal injury, stop the bleeding and restore the integrity of the internal organs.
rejection of this method must be justified, as the expectant management may be fatal for the patient.The accuracy of diagnostic laparoscopy and significantly increase the paracentesis.