Abdominal Trauma

Abdominal trauma is a common complaint in the emergency department. Penetrating abdominal injuries occur secondary to stab wounds or gunshot wounds. Blunt abdominal trauma most frequently occurs as a result of motor vehicle collisions. The diagnosis and management of abdominal injuries are guided by a combination of hemodynamic status, physical examination, and extended focused assessment with sonography for trauma (e-FAST), as well computed tomography (CT) scan when indicated and local wound exploration (LWE) in certain penetrating injuries. In general, emergent laparotomy is indicated for patients with abdominal injuries in the setting of hemodynamic compromise, peritoneal signs, evisceration, or diaphragmatic injury. Patients not meeting these criteria undergo further diagnostic testing to further delineate and risk stratify their injuries and ensure appropriate disposition. Laparoscopy, extended observation with serial exams, and therapeutic angiography may be indicated depending on clinical and diagnostic findings.