A high index of suspicion is mandatory in potential abdominal trauma as signs and symptoms may be subtle or evolve slowly. In the majority of instances, injury results from blunt impact following a road traffic accident. Abdominal and genitourinary trauma vicki bacidore abdominal injuries are a significant source of morbidity and mortality, ranking third as a cause oftraumatic death, preceded only by injuries to the head and chest. Abdominal and genitourinary trauma authorstream presentation. Few surgeons have extensive experience with massive abdominal solid organ injury requiring immediate surgery.
Genitourinary trauma an overview sciencedirect topics. Started in 1995, this collection now contains 6769 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Other injuries often take priority over injuries to the genitourinary gu system and may initially interfere or postpone a complete urologic assessment. Chapter 47 genitourinary trauma episode overview 1. Ct with iv contrast is the gold standard in assessing renal and gu trauma more sensitive and specific than ivp, ultrasound, or angiography however, can miss significant injuries to the renal pelvis, collecting system and ureter given ct generally obtained before contrast is excreted in the urine. Ppt abdominal trauma powerpoint presentation free to. Timely identification and management of blunt genitourinary injuries. Genitourinary trauma knowledge for medical students and. Contains organs that make up digestive, urinary, and genitourinary systems. Methods this retrospective study evaluated patients requiring emergency surgery for abdominal trauma at a level 1 trauma center over 30 years 19802010. It may result in high morbidity if not properly identified and managed. Timely identification and management of genitourinary injuries can minimize the associated morbidity, which may include impairment of urinary continence and sexual function.
Blood in the urine after abdominal trauma suggests a urinary tract injury. Abdominal and genitourinary trauma recognition and. In europe, blunt abdominal trauma accounts for the majority of remaining. Abdominal trauma may involve penetrating or blunt injuries.
Neurologic injuries including spinal cord injury, chest and abdominal injuries, head injuries and extremity injuries can be associated with pelvic fractures. Flank abdominal rib back pelvic scrotal pain worry in cases of pelvic. Genitourinary trauma, kidney trauma, abdominal trauma, emergency nursing, renal trauma, ureter trauma, bladder trauma. This episode of crackcast covers rosens chapter 047, genitourinary trauma. Approximately 10 percent of patients suffering injuries severe enough to require admission to a trauma service sustain injury to the genitourinary tract. Ct with iv contrast excellent for kidney and ureter but not bladderpatient must have a retrograde cystogram ct.
Given the increasing alacrity and accuracy of ct angiography in the evaluation of abdominal trauma. The kidney is the third most common abdominal organ to be injured in trauma, following. In general, renal vascular injuries occur in less than 5% of blunt abdominal trauma, while isolated. In children with genitourinary tract trauma, renal parenchymal lesions are the most prevalent injuries. Damage to the kidney represents the most common type of urinary tract injury. None none abdominal compartment syndrome splenic injury pediatric trauma renal trauma. Cureus impact of genitourinary injuries on patients.
Blast phase caused solely by the direct effect of overpressure. Introduction in patients having emergency abdominal surgery for trauma, the presence of urologic injury tends to increase mortality and morbidity. Imaging plays a crucial role in the evaluation of the genitourinary tract in a patient who has suffered either blunt or penetrating trauma because multiorgan injury is common in such patients. The gu system is divided into three regions, each with its own pattern of injury. The patient is unstable and is experiencing obvious signs and symptoms. Green final or blue national or abdominal trauma has the potential to cause severe bleeding and hemorrhagic shock o it is important to recognize mechanisms of injury and signs and symptoms of abdominal traumatrauma to the external genitalia also can produce severe blood lossthe abdominal cavity is bounded by the. Applies fundamental knowledge to provide basic emergency care and transportation based on assessment findings for an acutely injured patient. Injuries to the abdomen that go unrecognized or are not repaired in.
It begins by providing a brief explanation of databases that have been recently used to study this patient population, then proceeds to discuss each genitourinary organ individually, discussing the most relevant and up to date information published for each one. See initial management of trauma in adults and initial evaluation and management of blunt abdominal trauma in adults and pelvic trauma. Pelvic vein disruption can lead to life threatening hemorrhage. You are transporting a patient with blunt abdominal trauma. In these cases, additional imaging studies to assess for genitourinary injury occur later, outside of the emergency department.
Bladder and urethral injuries are suggested by pelvic fractures. Describe some special considerations related to the care of pediatric patients and geriatric patients who have experienced abdominal trauma. Because trauma is a multisystem disease, multiple injuries may be present in the trauma patient. The lower tract consists of the bladder and the posterior portion of the urethra. Chapter 11 genitourinary injuries test questions strac. Study 5 chapter 35 abdominal and genitourinary trauma flashcards from shelby g. Chapter 35 abdominal and genitourinary trauma yellow quiz or. Mohamed shafikurology department alexandria university 2. Genitourinary trauma involves injury to the kidneys, ureters, bladder, andor urethra. Blunt lower abdominal trauma with a distended bladder the blunt forces stretch the weaker dome of the bladder. Abdominal and genitourinary trauma unit flashcards quizlet.
Hollow organ injuries stomach usually injured due to blunt trauma full stomach prior to incident risk of injury spillage of contents into peritoneal cavity immediate pain, tenderness, guarding, and rigidity small and large intestines usually injured due to penetrating trauma spillage of contents into. The urethral meatus should be examined after trauma. Chapter 36 abdominal and genitourinary trauma flashcards. Chapter genitourinary system first nations and inuit health branch fnihb pediatric clinical practice guidelines for nurses in primary care. Abdominal trauma is responsible for about 10% of all deaths related to trama. Rupture of this organ leads to spilling of acidic material. Overview of genitourinary trauma society of urologic nurses. The presence of tachycardia following a significant abdominal injury. Chapter 30 abdominal and genitourinary injuries send article as pdf. Abdominal and genitourinary trauma abdominal and genitourinary trauma steve lan. Abdominal, suprapubic, flank or back pain or tenderness scrotal or groin pain genital sores, swelling, discolouration. Discuss the types of traumatic injuries sustained by the male and female genitourinary system.
Chapter 6 abdominal and genitourinary trauma youtube. Injury to this may cause spilling of abdominal contents into the thoracic cavity. Approximately 10% of trauma patients sustain injury to the genitourinary system. Three mechanisms of injury exist blunt, penetrating and blast. Penetrating genitourinary trauma has a more straightforward imaging approach than blunt trauma. Start studying abdominal and genitourinary trauma unit. Special attention was given to patients with concomitant genitourinary gu injuries. The majority of these injuries approximately 80% are the result of a blunt trauma mechanism. A free powerpoint ppt presentation displayed as a flash slide show on id.
Blunt abdominal trauma affects the liver and the spleen more often than the kidney. Following principles of vascular injury in the retroperitoneum, all zone 2 perinephric. Renal injuries are suggested by lower rib fractures. These patient presentations can range from subtle injuries all the way to gross. Although both penetrating and blunt injuries are common, blunt abdominal trauma is the leading cause of death and disability across all. Renal trauma is most often an acute condition caused by a blunt abdominal. Blunt and penetrating abdominal trauma can cause significant injury to the genitourinary organs, and radiologic imaging plays a critical role both in diagnosing. Genitourinary injury occurs in 25% of all trauma patients and in at least 10% of patients with abdominal trauma, emphasizing the need for a close collaboration between the. Abdominal trauma blunt unstable evisceration peritonitis stable unstable stable fluid in okabdomen no fluid concern. Knowledge of genitourinary system anatomy is essential to evaluating and treating traumatic urologic injuries. The role of interventional radiology in urologic tract trauma.
Associated genitourinary trauma is seen in 1112% of pelvic fractures. Timothy evans, md, facep associate professor, department of emergency medicine, virginia commonwealth universitymedical college of virginia hospitals and christine murphy, md, resident iii, department of emergency medicine, virginia commonwealth universitymedical college of virginia hospitals in. Chapter 35 abdominal and genitourinary trauma emt i 101. In many cases, laparotomy may be needed to assess for other abdominal and pelvic injuries. Urinary system injuries occur in approximately 4% of trauma. Renal injuriesrenal injuries ureteral injuries bladder injury urethral injuries 3.
Contrastenhanced ct is the primary imaging technique used to evaluate the upper and lower urinary tract for trauma. Genitourinary trauma, kidney trauma, abdominal trauma, emergency nursing, renal trauma, ureter trauma, bladder trauma, urethral trauma. Our colleagues in adult trauma care have slowly acknowledged this success and applied many of the principles learned in pediatric trauma to their patients. Urologic nursing editorial board statements of disclosure in accordance with ancccoa governing rules urologic nursingeditorial board statements of disclosure are published with each cne offering. Demonstrate how to apply a dressing to an abdominal evisceration wound. The diagnosis of genitourinary trauma typically relies on patient history, physical examination, urinalysis, and imaging ct, cystoscopy, retrograde urethrogram. Injuries to the lower genitourinary gu tract alone are not life threatening, but their association with other potentially more significant injuries necessitates an organized approach to diagnosis and management. Blunt and penetrating abdominal trauma can cause significant injury to the genitourinary organs, and radiologic imaging plays a critical role both in diagnosing these in. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Explain assessment of a patient who has experienced an abdominal injury. Start studying chapter 36 abdominal and genitourinary trauma. Penetrating injuries include gunshot and shrapnel injuries, impalements, and knifings.
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