Perspectives on the Management of Abdominal Trauma

Abstract

The main consequences of abdominal trauma are haemorrhage and sepsis. Early deaths following abdominal trauma are usually attributable to haemorrhage. Sepsis is the most common cause in deaths occurring more than 48 hours after injury. Thus the first priority for the surgeon performing a laparotomy for abdominal trauma is haemorrhage control and prevention of spilling of visceral contents from visceral injuries is the second priority. In selected patients definitive repair is delayed until after a period of intensive resuscitation following damage-control surgery. The diagnosis or exclusion of hollow viscus injuries can be problematic. Excluding the general principles of trauma laparotomy and definitive intraabdominal procedures, the article discussed the clinical assessment and decisionmaking which would ensure that injuries are not missed during laparotomy and thus decrease mortality.