Introduction Injuries include (specifics below) abdominal wall injuries spleen injuries liver injuries kidney injuries testicular and penile injuries Risk factors contact sports and direct blows are risk factors for visceral injury deceleration pattern of injury is more likely to cause injury to the spleen, liver, or kidney Diaphragmatic Spasm Commonly known as "wind knocked out" caused by a direct blow to epigastrium causing diaphragmatic spasm Treatment observation resolves spontaneously may continue play Abdominal Wall Injury / Rectus Sheath Hematoma Introduction injury to epigastric or intramuscular vessels Presentation acute pain in a localized area is usually a sign of abdominal wall injury symptoms mimic surgical abdomen with nausea and vomiting pain with active trunk flexion or rotation Evaluation diagnosis can be made with CT Treatment nonoperative ice and rest indications most cases operative surgery decompression indications required if persistent progression and pain Spleen Injuries Introduction the most common organ injured in the abdomen as the result of blunt trauma most common cause of death because of an abdominal injury increased risk with splenomegaly after infectious mononucleosis Presentation nausea and vomiting sharp LUQ pain that becomes dull after a time and more diffuse localized pain that progresses to diffuse pain is concerning for visceral injury Evaluation diagnosis can be made with CT Treatment nonoperative clinical observation indicated in most cases operative splenectomy indicated only in severe injuries Liver Injury Introduction the liver is the second most commonly injured organ. Presentation symptoms include right upper quadrant pain that may radiate to right shoulder Evaluation diagnosis can be made with CT Treatment nonoperative conservative treatment with monitoring and rest Kidney Injuries Introduction more common in contact athletes usually occurs with blunt abdominal trauma to flank Presentation look / ask for hematuria Evaluation diagnosis can be made with CT Treatment operative urgent surgery indications extensive bleeding with renal fx or vascular pedicle injury Penile & Testicular Injuries Pudendal nerve neuropraxia introduction common in bicyclists presentation causes penile shaft numbness treatment nonoperative seat modifications Testicular Injury introduction mechanism is usually a kick leads to rupture of tunica albuginea (outer covering) causes a hematocoele presentation painful firm scrotal mass that does not transilluminate diagnosis ultrasound by urology treatment observation