Abdmonial Trauma

Last Updated on by FRCEM Intermediate

Indications for emergency laparotomy in blunt abdominal trauma

  • Peritonism
  • Free air under the diaphragm
  • Significant gastrointestinal hemorrhage
  • Hypotension with positive FAST scan or positive DPL

Indications for emergency laparotomy in penetrating abdominal trauma

  • Peritonism
  • Free air (in stab wounds may represent the introduction of external air rather than gastrointestinal perforation)
  • Evisceration
  • Hypotension (hemodynamic instability)
  • Gunshot wound traversing peritoneum or retroperitoneum
  • GI bleeding following penetrating trauma
  • penetrating object is still in situ (risk of precipitous haemorrhage on removal)

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