Abdominal Emergency – Trauma

Abdominal Emergency – Trauma

Types

1. Blunt Trauma – results when energy from force to the abdomen is diffused into the cavity (example: vehicular accident, contact sports, falls, physical abuse)
2. Penetrating Trauma – results from many forces (example: gunshot/stab wounds)

Signs and Symptoms

• Gastrointestinal bleeding
• diagnosed through:
• presence of pain
• palpitation
• Endoscopic examination
• Acute bleeding can be life threatening due to underlying gastro-intestinal disease
• Cullen’s Sign – darkened skin around umbilicus
• Anorexia
• Nausea and vomiting
• Weakness
• Constipation
• Diarrhea
• Weight loss
• Discomfort
• Abdominal pain
• Hematemesis – bright red bloody vomitus
• Hematochezia – bright red or maroon blood passes the rectum
• Melena – black tarry stool

Pathophysiology - Gastroesophageal Reflux Disease

Gastroesophageal Reflux Disease (GERD)

• Also known as reflux esophagitis – esophageal mucosa breaks down
• Syndrome resulting from esophageal reflux
• Manifestations are often overlooked and attributed to stress
• 10% of the population has daily GERD

Etiology

• Inappropriate relaxation of the LES (exact cause is unknown)
• Reflux occurs with
• Alteration in the intervention of the pressure zone in the region of the gastroesophageal sphincter
• Displacement of the angle of the gastroesophageal junction
• An incompetent LES

Risk Factors

• Obesity and weight gain
• Pregnancy
• Chewing tobacco/smoking
• High-fat foods
• Theophylline
• Caffeine and chocolates
• High levels of estrogen and progesterone

Pathophysiology

Normally, there is high-pressure zone in the region of the gastroesophageal sphincter and high pressure prevents reflux but permits passage of food and liquids. When there is alteration, reflux occurs.