Abdominal Trauma
Penetrating Injury to the Abdomen
The fellow should be able to:
- Demonstrate an understanding of the evaluation of patients presenting with a penetrating wound to the abdomen
- Describe the role of wound exploration, DPL, CT scan, and diagnostic laparoscopy in determining fascial penetration
- Understand the role and indication for non-operative management of penetrating abdominal injury
Resources
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Topic Summary
- Meet the Mentors - Damage Control: The Story Behind the Story
- Additional Resources:
- John J. Como, MD; Faran Bokhari, MD; et al., J Trauma 2010.
Practice Management Guidelines for Selective Nonoperative Management of Penetrating Abdominal Trauma
- Biffl WL, Leppaniemi A (2015) Management Guidelines for Penetrating Abdominal Trauma. World J Surg 39:1373-1380
- Walter L. Biffl, MD; Krista L. Kaups, MD; et al., J Trauma 2011.
Validating the Western Trauma Association Algorithm for Managing Patients with Anterior Abdominal Stab Wounds: A Western Trauma Association Multicenter Trial
- Smyth L, Bendinelli C, Lee N, Reeds MG et al (2022) WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment. World J Emerg Surg 17:13
- Lenart EK, Lewis RH, Sharpe JP, Fischer PE, Croce MA, Magnotti LJ (2020) They only come out at night: Impact of time of day on outcomes after penetrating abdominal trauma. Surg Open Sci 2:1-4
- Wolmarans A, Fru PN, Moeng MS (2023) Accuracy of CT scan for Detecting Hollow Viscus Injury in Penetrating Abdominal Trauma. World J Surg 47:1457-1463
- Roberts DJ, Faris PD, Ball CG, Kirkpatrick AW et al (2021) Variation in use of damage control laparotomy for trauma by trauma centers in the United States, Canada, and Australasia. World J Emerg Surg 16:53
- Stephanie R. Goldberg, MD; Rahul J. Anand, MD; et al., J Trauma Acute Care Surg 2012.
Prophylactic antibiotic use in penetrating abdominal trauma: An Eastern Association for the Surgery of Trauma practice management guideline
- John J. Como, MD; Faran Bokhari, MD; et al., J Trauma 2010.
- WTA Algorithm:
- EAST Guidelines:
Abdominal Wall Injuries
The fellow should be able to:
- Understand risk factors for traumatic abdominal wall hernias and associated injuries
- Describe indications and timing of operative repair of traumatic abdominal wall injuries
- Describe operative techniques for repair of traumatic abdominal wall hernias, including different approaches and repair techniques
- Describe complications associated with traumatic abdominal wall injuries
- Understand the diagnosis and management, including operative and non-operative, of Morell-Lavalee lesions
Resources
- Topic Summary
- Meet the Mentors - Traumatic Abdominal Wall and Associated Injuries
Abdominal Damage Control and Open Abdomen
The fellow should be able to:
- Demonstrate an understanding of the role of damage control surgery in abdominal trauma including indications
- Understand the diagnosis and management of abdominal compartment syndrome
- Understand the complications associated with the use of an open abdomen
- Describe the options for performing temporary abdominal closure and advantages/disadvantages of each
- Describe the options for abdominal closure when the fascia cannot be closed
- Understand the advantages/disadvantages of biologic vs absorbable mesh closure
- Understand the options available for abdominal wall reconstruction following planned hernias
Resources
-
Topic Summary
- AAST Education Module - Abdominal Compartment Syndrome
- AAST Education Module - Management of the Complicated Hernia
- Overview Article:
- Eric J. Mahoney< MD, FACS; Nikolay Bugaev, MD; et al., J Trauma Acute Care Surg 2022.
Management of the open abdomen: A systematic review with meta-analysis and practice management guideline from the Eastern Association for the Surgery of Trauma
- Eric J. Mahoney< MD, FACS; Nikolay Bugaev, MD; et al., J Trauma Acute Care Surg 2022.
- Additional Resources:
- Ribeiro-Junior MAF, Costa CTK, de Souza Augusto S, Néder PR, Elia YGB, Rattan R; Peritoneal Resuscitation Study Group; Di Saverio S. The role of direct peritoneal resuscitation in the treatment of hemorrhagic shock after trauma and in emergency acute care surgery: a systematic review. Eur J Trauma Emerg Surg. 2022 Apr;48(2):791-797. doi: 10.1007/s00068-021-01821-x. Epub 2021 Nov 13. PMID: 34773466.
- Federico Coccolini, Derek Roberts, et al., World J Emerg Surg 2018.
The open abdomen in trauma and non-trauma patients: WSES guidelines
- Osvaldo Chiara, MD; Stefania Cimbanassi, MD; et al., J Trauma Acute Care Surg 2016.
International consensus conference on open abdomen in trauma
- EAST Guidelines: