Injuries in the region increase the likelihood of chest, mediastinal, and diaphragmatic injuries. - The area superiorly delimited by the fourth intercostal space (anterior), sixth intercostal space (lateral), and eighth intercostal space (posterior), and inferiorly delimited by the costal margin (definitions vary - a pragmatic approach is to use the nipple line as the upper boundary… in non-obese men at least!).Between the anterior axillary lines bound by the costal margin superiorly and the groin crease distally. These are the 4 regions of the abdomen to consider in penetrating injury: If the wound was caused by a projectile, then a penetrating abdominal injury could result from an entry wound in almost any part of the body.Any wound between the nipple line (T4) and the groin creases anteriorly, and from T4 to the curves of the iliac crests posteriorly is potentially a penetrating abdominal injury.gunshot wounds) and non-projectiles (e.g. Most patients with significant penetrating injury require laparotomy there are differences in the management of projectiles (e.g. organs most affected are : spleen > liver > small and large intestine.Common mechanisms include road traffic crashes, falls, sports injuries and assaults. Assessment of abdominal trauma requires the identification of immediately life-threatening injuries on primary survey, and delayed life threats on secondary survey.Ībdominal trauma is classified as blunt or penetrating, assessment and management is modified accordinglyīlunt abdominal injuries often managed conservatively, though interventional radiology and surgery are indicated for severe injuries
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