Trauma is the most common cause of death in the young population,
predominantly males. Abdominal trauma is a leading source of occult bleeding which
is the second cause of early-phase deaths following major head injury. Uncontrollable
bleeding constitutes the most common cause of preventable deaths especially if the
management of shock is delayed. Penetrating trauma leads to significant morbidity and
mortality, nonetheless, diagnosed more easily with its remarkable presentation.
The main goal in the evaluation of the abdomen in the acute setting is to uncover (i.e.,
not to overlook) the injuries requiring surgery without delay, rather than to diagnose
specific injuries in detail. Signs and symptoms of progressing shock states vary from
patient to patient, and sometimes very subtle changes can herald impending doom.
The clinician should be proactive in detecting the injuries, using both evaluation
findings and bedside ultrasound together with other advanced imaging techniques when
necessary, keeping in mind that occult injuries can evolve in time insidiously. Ongoing
intraabdominal bleeding is an ominous finding which precedes advanced hemorrhagic
shock and needs to be sought for carefully in patients with trauma.
Keywords: Abdominal pain, Abdominal trauma, Bleeding, Computed tomography, Fluid management, Hemorrhagic shock, Injury, REBOA, Resuscitation, Rupture, Shock, Trauma, Ultrasound.
