Management Of Blunt Abdominal Trauma - Surgery скачать в хорошем качестве

Management Of Blunt Abdominal Trauma - Surgery

📌 𝐅𝐨𝐥𝐥𝐨𝐰 𝐨𝐧 𝐈𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:-   / drgbhanuprakash   📌𝗝𝗼𝗶𝗻 𝗢𝘂𝗿 𝗧𝗲𝗹𝗲𝗴𝗿𝗮𝗺 𝗖𝗵𝗮𝗻𝗻𝗲𝗹 𝗛𝗲𝗿𝗲:- https://t.me/bhanuprakashdr 📌𝗦𝘂𝗯𝘀𝗰𝗿𝗶𝗯𝗲 𝗧𝗼 𝗠𝘆 𝗠𝗮𝗶𝗹𝗶𝗻𝗴 𝗟𝗶𝘀𝘁:- https://linktr.ee/DrGBhanuprakash Management of Blunt Abdominal Trauma Introduction Blunt abdominal trauma (BAT) is a significant cause of morbidity and mortality, often resulting from motor vehicle accidents, falls, or assaults. The management of BAT requires prompt assessment, accurate diagnosis, and appropriate intervention to prevent complications. Initial Assessment Primary Survey (ABCDE Approach) Airway: Ensure a patent airway. Cervical spine protection is mandatory if there is a suspicion of spinal injury. Breathing: Assess for adequate ventilation. Look for signs of pneumothorax or hemothorax. Circulation: Evaluate for hemorrhagic shock. Control external bleeding, assess pulse, blood pressure, and capillary refill time. Disability: Rapid neurological assessment using the Glasgow Coma Scale (GCS). Exposure/Environment: Complete exposure to assess for other injuries while preventing hypothermia. Secondary Survey History and Physical Examination**: Obtain AMPLE history (Allergies, Medications, Past medical history, Last meal, Events surrounding injury). Conduct a thorough abdominal examination for tenderness, distension, rigidity, or abrasions. FAST (Focused Assessment with Sonography for Trauma)**: A rapid bedside ultrasound to detect free intraperitoneal fluid (suggestive of hemoperitoneum). CT Scan: The gold standard for stable patients, providing detailed imaging to identify organ injuries such as liver lacerations, splenic injuries, or retroperitoneal hematomas. Diagnostic Peritoneal Lavage (DPL): Used less frequently now, DPL is indicated when FAST is inconclusive, and the patient is hemodynamically unstable. It involves instillation of saline into the peritoneal cavity and retrieval of fluid for analysis. Management Strategies Non-Operative Management (NOM) Indications: Hemodynamically stable patients with isolated solid organ injury (liver, spleen, kidney) and no signs of peritonitis. Monitoring: Continuous monitoring in the Intensive Care Unit (ICU) with serial hemoglobin/hematocrit levels, vital signs, and abdominal examinations. Interventions: Embolization may be performed in cases of ongoing bleeding detected on CT angiography. Complications: Delayed hemorrhage, infection, and missed injuries require vigilant monitoring. Operative Management Indication: Hemodynamic instability, peritonitis, evisceration, or positive DPL in unstable patients. Procedures: Laparotomy: Indicated for patients with signs of peritoneal irritation, uncontrolled hemorrhage, or when non-operative management fails. Damage Control Surgery: Employed in critically injured patients with massive bleeding. The goal is to control hemorrhage and contamination, followed by temporary abdominal closure and subsequent definitive surgery after stabilization. Organ-Specific Interventions Liver: Hemostasis is achieved by packing, Pringle maneuver (occlusion of the hepatoduodenal ligament), or hepatorrhaphy. Major hepatic resections are avoided due to high mortality. Spleen: Splenectomy or splenorrhaphy depending on the extent of injury. Splenic preservation is preferred to avoid post-splenectomy infections. Bowel and Mesenteric Injuries**: Resection of devitalized bowel with primary anastomosis or stoma formation, depending on the patient’s stability. Postoperative Care ICU Monitoring: Patients require close monitoring in the ICU for hemodynamic stability, respiratory function, and potential complications. Antibiotic Therapy: Prophylactic antibiotics are administered to prevent infection, especially in cases of hollow organ perforation. Nutritional Support: Early enteral feeding is preferred to maintain gut integrity and prevent bacterial translocation. Complications Infections: Intra-abdominal abscesses, wound infections, sepsis. Hemorrhage: Postoperative bleeding or delayed hemorrhage. Organ Failure: Acute renal failure, respiratory distress syndrome. Long-Term Sequelae: Adhesions, chronic pain, and psychological trauma. #fmge #fmgevideos #rapidrevisionfmge #fmgejan2023 #mbbslectures #nationalexitexam #nationalexittest #neetpg #usmlepreparation #usmlestep1 #fmge #usmle #drgbhanuprakash #medicalstudents #medicalstudent #medicalcollege #neetpg2023 #usmleprep #usmlevideos #usmlestep1videos #medicalstudents #neetpgvideos #surgeryeducation