Abdominal and Pelvic Trauma Flashcards

A patient arrives after a motorcycle crash with a rigid, distended abdomen and hypotension. What is the most appropriate initial diagnostic study?

Answer: Focused Assessment with Sonography for Trauma (FAST)

FAST is the preferred initial assessment in hemodynamically unstable trauma patients as it rapidly identifies free intraperitoneal fluid without delaying resuscitation.

Which organ is most commonly injured in blunt abdominal trauma?

Answer: Spleen

The spleen is the most commonly injured solid organ in blunt abdominal trauma due to its anatomic position and relatively fragile parenchyma.

A stab wound to the left lower chest at the 7th intercostal space should raise suspicion for injury to which abdominal organ?

Answer: Spleen

The thoracoabdominal region contains the upper abdominal organs beneath the diaphragm, and left-sided wounds in this zone frequently injure the spleen.

What is the most reliable indicator of intra-abdominal hemorrhage requiring surgical intervention in an unstable trauma patient?

Answer: Positive FAST exam

A positive FAST exam in a hemodynamically unstable patient is the most reliable bedside indicator of significant intra-abdominal hemorrhage requiring emergent surgical exploration.

A hemodynamically stable patient with a Grade III splenic laceration on CT is best managed with which approach?

Answer: Nonoperative management with observation

Hemodynamically stable patients with Grade I-III splenic injuries are typically managed nonoperatively with serial abdominal exams, hemoglobin monitoring, and bed rest, achieving success rates of over 90%.

Which finding on diagnostic peritoneal lavage (DPL) is considered positive for significant intra-abdominal injury?

Answer: RBC count >100,000/mm3 in blunt trauma

A red blood cell count exceeding 100,000/mm3 in the DPL effluent is the standard threshold for a positive result in blunt trauma.