Treatment of common abdominal injuries

Closed abdominal trauma, also known as abdominal trauma, is a concept that refers to all injuries to the abdomen, including outside the abdominal wall and also in solid intra-abdominal organs such as spleen, liver, pancreas... mixed with hollow viscera such as intestines, bladder, stomach, some combined injuries...
Closed abdominal trauma is the 4th leading cause of death globally and the leading cause of death among people under 45 years old.
Some symptoms of blunt abdominal trauma
When suffering from blunt abdominal trauma, patients may experience many different symptoms, some of which are typical:
Abdominal pain: this is a common symptom. best. The site of pain usually occurs in the affected area; Vomiting; Frequent urination, urine may be clear or bloody.

The diagnosis of blunt abdominal trauma is quite difficult due to the following reasons:
The patient has many other combined injuries that distract the diagnosis; The patient's consciousness is impaired due to more serious trauma such as traumatic brain injury, or poisoning.... Therefore, besides clinical examination by some traditional methods, laboratory tests. Others should also be conducted to accurately determine the patient's condition.
2.1 Blood tests Blood tests to check for blunt abdominal trauma may include:
Checking the red blood cell count, hematocrit and hemoglobin...; Check white blood cell count and neutrophil count; Check the patient's blood type (A, B or O).

2.2 Abdominal ultrasound Abdominal ultrasound is a type of ultrasound in closed abdominal trauma with relatively high reliability, however, it should only be applied to patients with suspected disease but not in general shock. For patients who are showing signs of shock, it is necessary to use local ultrasound to quickly detect lesions in solid organs...
In addition, in some special cases, it is necessary to use upright abdominal X-ray technique. .
2.3 Computed tomography CT Abdominal computed tomography is a means of diagnosing blunt abdominal trauma with images of very high value in detecting lesions in viscera, especially solid viscera.

3.1 Liver rupture Liver rupture is very common in patients with severe abdominal trauma. There are about 50% of cases of liver rupture without bleeding in the early stages.
Regarding the treatment of liver rupture, doctors can choose one of the following methods to best suit the patient and liver rupture:
Grade 1 and 2: The most common method is liver suturing ;. Grade 3, 4: Can tie blood vessels along the liver tear line, or cut ligaments, columnar hepatic artery, Dexon Mesh...; Grade 5: liver resection and can be combined with Atrial - Portal Shunt method; Grade 6: liver transplant. 3.2 Spleen rupture The spleen is the most vulnerable solid organ in the abdomen. However, because the spleen is an extremely important part of human life activities, the preservation of the spleen after trauma in both children and adults is a priority requirement.
The treatment of splenic rupture usually uses 1 of 3 main methods, depending on the patient's current level of splenic rupture:
Grade 1 and 2: preserving the spleen, limiting non-surgical; Grade 3: requires surgery but not complete surgery, using a combination of PACKING and retroperitoneal inclusion of spleen; Grade 4 or higher: Splenectomy is required. In some cases, the following patients are recommended to use spleen-conserving treatment:
The patient has no lesions in solid and other hollow viscera (no associated blunt abdominal trauma); Hemodynamics remained stable and HCT > 25%; CT-SCAN assesses the degree of injury at grade 1 and grade 2. 3.3 Duodenal rupture Duodenal rupture usually occurs because the patient experiences pressure on the abdominal wall or shock. Normally, the duodenum is located deep behind the peritoneum. Therefore, if the duodenal rupture is severe, the probability of death after surgery is up to 27.2%.

Similar to liver and spleen rupture, duodenal rupture is also treated depending on the severity of the disease:
Grade 1: Prefer non-surgical conservative treatment, including gastric drainage, parenteral nutrition. .. The surgery in this case is less than ideal, because it can cause the formation of a large hematoma and lead to duodenal obstruction; Grade 2 and 3: suture anastomosis in the duodenum; Grade 4: using WHIPPLE surgery. In addition, a number of other methods will also be added to support treatment, including:
Open gastric bypass and duodenal suction; Gastro-colon connection; Jejunostomy: a way to drain the duodenum and with it duodenal feeding. In short, there are many types of blunt abdominal trauma, each with its own specific treatment. However, all of these types of injuries have the potential to cause death or serious complications. Therefore, you need to check soon after major collisions to detect and handle promptly.
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