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    9 Abdomen

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    Merlin Merliana
    This document discusses trauma to the abdomen. It covers: 1. Damage control surgery principles for abdominal trauma including stopping bleeding and contamination. 2. Mechanism of injury, injury sustained, symptoms, and time are important to consider (MIST). 3. Bleeding in the abdomen can come from the chest, abdomen, pelvis, femur or retroperitoneum. 4. Intra-abdominal organ injury from blunt or penetrating trauma may cause bleeding, organ damage or peritonitis and requires laparotomy.

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    9 Abdomen

    Uploaded by

    Merlin Merliana
    6 views19 pages
    This document discusses trauma to the abdomen. It covers: 1. Damage control surgery principles for abdominal trauma including stopping bleeding and contamination. 2. Mechanism of injury, injury sustained, symptoms, and time are important to consider (MIST). 3. Bleeding in the abdomen can come from the chest, abdomen, pelvis, femur or retroperitoneum. 4. Intra-abdominal organ injury from blunt or penetrating trauma may cause bleeding, organ damage or peritonitis and requires laparotomy.

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    abdomen

    Original Title

    9.Abdomen

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    This document discusses trauma to the abdomen. It covers: 1. Damage control surgery principles for abdominal trauma including stopping bleeding and contamination. 2. Mechanism of injury, injury sustained, symptoms, and time are important to consider (MIST). 3. Bleeding in the abdomen can come from the chest, abdomen, pelvis, femur or retroperitoneum. 4. Intra-abdominal organ injury from blunt or penetrating trauma may cause bleeding, organ damage or peritonitis and requires laparotomy.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as ppt, pdf, or txt
    6 views19 pages

    9 Abdomen

    Uploaded by

    Merlin Merliana
    This document discusses trauma to the abdomen. It covers: 1. Damage control surgery principles for abdominal trauma including stopping bleeding and contamination. 2. Mechanism of injury, injury sustained, symptoms, and time are important to consider (MIST). 3. Bleeding in the abdomen can come from the chest, abdomen, pelvis, femur or retroperitoneum. 4. Intra-abdominal organ injury from blunt or penetrating trauma may cause bleeding, organ damage or peritonitis and requires laparotomy.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 19

    Trauma

    Abdomen
    TRAUMA
    ATLS A, B, C, D & E
    DSTC (Definitive Surgery For
    Trauma Care)
    Damage Control Surgery
    (Stop Bleeding Packing
    & Stop Contamination)
    Compartment Syndrome
    DSTC M Mech. Of Injury
    I Injury Sustained
    S Symptoms
    T Th/
    Trauma
    Syok Hemorhagik Sumber
    Perdarahan ;
    Toraks
    Abdomen
    Pelvis
    Femur
    Retroperitoneal
    Intra dan
    Retro
    peritoneal :
    Hepar
    Lien
    Organ Solid Pankreas
    Ginjal

    Organ
    Abdomen

    = Lambung->
    Organ Berongga -> rektum

    Intra / retroperitoneal
    Trauma tajam (Tembus, Tusuk,
    Tembak
    High Velocity /
    Low Velocity)

    Trauma Trauma tumpul (Benda Keras,


    Handle Bar Injury)
    Abdomen

    Organ Intraperitoneal - Solid


    - Berongga

    Organ Retroperitoneal - Solid


    - Berongga
    Cedera Organ Intra-peritoneal

    1. Solid (hepar/lien) Perdarahan


    Intraperitoneal
    - rangsangan peritoneal
    (nyeri-nyeri tekan *)
    - tanda darah intra-perit.
    - tanda perdarahan
    (syok-pucat)

    2. Berongga
    Sering sulit DD/ !
    DPL (Diagnostic Peritoneal
    Lavasage)
    FAST (Focussed
    Assessment with Sonography
    for Trauma)
    Cedera Organ Intra-peritoneal

    1. Solid (hepar/lien)
    2. Berongga Peritonitis Umum
    (lambung rektum) - nyeri
    - defans
    - nyeri tekan
    - nyeri lepas*
    - pekak hepar

    Sering sulit DD/ !


    Foto Polos abdomen
    CT Scan / MS CT
    CURIGA !
    Cedera Organ Retro-peritoneal

    ( 1. Cedera uretra : ada trias : 1. 2. 3. )

    1.Ada perdarahan di OUE


    (meatal bleeding)

    2. Hematom skrotum

    3. RT : prostat melayang
    Cedera Organ Retro-peritoneal

    ( 1. Cedera uretra : ada trias : 1. 2. 3. )

    2. Cedera V.Urinaria : pasang kateter


    - hematuria minimal dan
    tidak bertambah

    3. Cedera Ginjal : pasang kateter


    - hematuria, jumlah normal

    Catatan : ruptur buli bila intraperitoneal


    akan peritonitis
    Cedera Organ Retro-peritoneal

    Duodenum Pankeas :

    - Manifestasi lambat : peritonitis

    - Udara retroperitoneal

    - Bila langsung menjadi intra-peritoneal


    langsung peritonitis
    Cedera Abdomen sering terlambat :

    1. Manifestasi sering lambat (perforasi)


    2. Ada cedera kepala (kesadaran menurun)
    3. Ada cedera spinal (gangguan sensorik)
    4. Cedera lain lebih nyeri
    5. Obat-obatan / alkohol)
    6. Cedera retroperitoneal

    Buktikan sejauh mungkin, lalu


    observasi terus menerus ???
    Diagnosis dan Pengelolaan
    Cedera Abdomen (1) :

    Anamnesis : mekanisme cedera (MIST ???)

    Survei primer : A B C D & E


    Pem. Fisik Abdomen :
    Insp Ausk Palp Perk

    Syok karena perdarahan intra-peritoneal :


    Perlu LAPAROTOMI !
    Diagnosis dan Pengelolaan
    Cedera Abdomen (2) :

    Survei Sekunder
    Pem. Fisik Abdomen :
    Insp Ausk Palp Perk

    Adjuncts : X-foto DPL FAST


    CT Scan MS CT Dsb

    Jelas cedera intra-abdomen


    Laparotomi
    Fraktur Pelvis
    Sederhana
    Dengan Syok
    Dengan kerusakan
    organ :
    - ruptur uretra
    - ruptur buli
    - perforasi rektum
    - kerusakan genitalia
    interna
    Fraktur Pelvis
    dengan
    Ruptur Buli
    Fraktur Pelvis :

    Dengan Syok : PASG / Gurita (pelvic binder)


    terapi definitif ?

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