Abdominal and Pelvic Trauma Flashcards

In a patient with a pelvic fracture and hemodynamic instability, what is the most appropriate initial intervention to control hemorrhage?

Answer: Application of a pelvic binder

A pelvic binder reduces pelvic volume and provides tamponade effect, serving as the first-line intervention for hemorrhage control in unstable pelvic fractures.

Which type of pelvic fracture is most commonly associated with life-threatening hemorrhage?

Answer: Anterior-posterior compression (open book) type III

AP compression type III fractures create the greatest pelvic volume expansion, disrupting the posterior pelvic ring and major vascular structures.

A patient has a positive FAST but is hemodynamically stable after a motor vehicle collision. CT reveals a Grade II liver laceration with no active extravasation. What is the recommended management?

Answer: Nonoperative management with serial monitoring

Hemodynamically stable patients with low-grade liver injuries and no active bleeding are best managed nonoperatively with close monitoring.

During laparotomy for abdominal trauma, damage control surgery principles are indicated when the patient develops which triad?

Answer: Hypothermia, acidosis, and coagulopathy

The lethal triad of hypothermia, metabolic acidosis, and coagulopathy indicates physiologic exhaustion and mandates abbreviated surgery with temporary closure.

Retroperitoneal duodenal injury is best diagnosed by which finding on CT scan?

Answer: Retroperitoneal air around the duodenum or right kidney

Retroperitoneal air around the duodenum or right kidney on CT is the hallmark finding of a retroperitoneal duodenal perforation.

What is the most appropriate initial management for a patient with a suspected bladder rupture following blunt pelvic trauma?

Answer: Retrograde cystography

Retrograde cystography is the gold standard diagnostic study for suspected bladder rupture, distinguishing intraperitoneal from extraperitoneal rupture.