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44-Hour Course

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Lesson no. 21

Abdominal Injuries

Abdominal Borders

  • Upper boundary – diaphragm
  • Lower boundary – groin and genital area
  • Anterior (front) boundary – abdominal muscles
  • Posterior (back) boundary – spine

Abdominal Organs

The abdominal organs are divided into two types:

 

  • Solid organs – organs full of tissue and blood, and injury to them can cause massive bleeding in the abdominal cavity (for example the liver, spleen) and sub-volume shock.
  • Hollow organs – digestive organs. When damaged, their contaminated contents will spill into the abdominal cavity and cause a severe infection of the abdominal cavity.

Injury Mechanisms and Possible Fractures

  • Blunt injury – as a result of a fall or a blow. Blunt injuries can cause a tear in the blood vessels in the abdomen and massive bleeding.
  • Penetrating injury – as a result of stabbing or shooting, for example.
  • Pelvic fractures – you can bleed two liters into the pelvis, with no external sign!
  • Lower rib fractures – these are the “floating” ribs (connected to the spine only). Fracture of these ribs may pierce organs in the area.

Signs

  • Hard stomach, pains
  • Feet folded in the fetal position
  • Hematoma in the stomach
  • Localized pain and sensitivity
  • Nausea
  • Vomiting and excretion with blood
  • Breathing difficulty
  • Bloody urine

Note

  • When exposing the abdomen, examine the abdomen and back.
  • Make sure to scout for foreign objects located in the abdomen/lower back.
  • If there is an open wound and an organ is coming out of the stomach, it should be bandaged with a wet and sterile dressing (an example of sterile fluid – infusion fluid, not water!).
  • If a foreign object is found (knife and more) – do not move or try to remove it!
  • The patient should not eat or drink.
  • The patient should be evacuated to the hospital immediately.

did you know?

  • The liver is the organ that tends to be most easily injured by blunt and penetrating abdominal injuries.
  • When we get hit in the stomach by the diaphragm area, the first minute is usually characterized by an inability to breathe and panic. This is caused by the fact that the blow has interrupted the diaphragm’s action and the diaphragm is an organ that aids the respiratory process.
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