canis - Articles
Abdomen: trauma
Introduction
- Cause: usually crush injury, eg road traffic accident, or penetrating abdominal wound.
- Signs: depends on organs involved but often abdominal pain and signs referable to hypovolemic shock.
- Diagnosis: history, point-of-care ultrasound, ultrasonography, radiography, laparotomy.
- Treatment: supportive and may require surgical intervention.
- Prognosis: often good with appropriate treatment.
Presenting signs
- Depends to some extent on organ(s) involved.
- Collapse, obtundation due to shock.
- Abdominal wall defect or bruising.
- Signs related to specific organ trauma:
- Abdominal pain; peritonitis, pancreatitis.
- Dysuria Dysuria investigation.
- Stranguria.
- Hematuria Hematuria.
Acute presentation
Special risks
- Penetrating wound, septic peritonitis, body wall rupture with incarcerated viscus indicators for emergency surgery.
- Patient may present in shock, have SIRS Systemic inflammatory response syndrome (SIRS) and organ dysfunction, eg coagulation, hepatic or renal which might affect anesthetic safety.
- If abdominal trauma has occurred there may be thoracic trauma Thorax: trauma - care in handling dyspneic patients.
Pathogenesis
Etiology
- Traffic accident.
- High rise.
- Dog bite.
- Impalement.
- Stabbing.
- Gunshot wound.
Pathophysiology
- Injury may involve any abdominal organ.
Urinary system
- Kidney rupture Kidney: trauma.
- Ureter avulsion Ureter: trauma.
- Ureter rupture Ureter: trauma.
- Bladder rupture Bladder: trauma rupture.
- Urethral rupture Urethra: rupture.
Liver
- Liver lobe rupture/hematoma Liver: trauma.
- Biliary tract rupture.
Spleen
- Rupture Spleen: trauma.
- Torsion.
Pancreas
- Pancreatitis Pancreas: trauma.
Gastrointestinal tract
- Rupture.
- Entrapment of intestines in torn mesentery.
- Mesenteric thrombosis.
Other
- Diaphragm rupture Diaphragm: traumatic hernia.
- Body wall rupture.
Timecourse
- If trauma is severe patient usually presents within hours of trauma.
- Peritonitis Peritonitis secondary to urinary or biliary tract leak may not present for days.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Lefman S, Prittie J E (2022) High-rise syndrome in cats and dogs. J Vet Emerg Crit Care (San Antonio) 32(5), 571-581 PubMed DOI: 10.1111/vec.13206.
- Lisciandro G R (2011) Abdominal and thoracic focused assessment with sonography for trauma, triage, and monitoring in small animals. J Vet Emerg Crit Care (San Antonio) 21(2), 104-122 PubMed DOI: 10.1111/j.1476-4431.2011.00626.x.
- Beal M A (2005) Approach to the acute abdomen. Vet Clin North Am Small Anim 35 (2), 375-396 PubMed.
- Heeren V, Edwards L, Mazzaferro E M (2004) Acute abdomen: diagnosis. Comp Contin Educ Pract Vet 26 (5), 350-363 VetMedResource.
- Heeren V, Edwards L, Mazzaferro E M (2004) Acute abdomen: treatment. Comp Contin Educ Pract Vet 26 (5), 366-373 VetMedResource.
Other sources of information
- Cortellini S & Humm K (2018) Abdominal trauma in dogs 2. management. In Practice 40(1), 2-10.
- Humm K & Cortellini S (2017) Abdominal trauma in dogs 1. emergency investigation. In Practice 39 (10), 434-445.