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 boxers and football players Presentation look / ask for hematuria but not always present 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 http://www.ncbi.nlm.nih.gov.ezproxy.galter.northwestern.edu/pubmed/16278543
QUESTIONS 1 of 2 1 2 Previous Next (OBQ09.216) A 17-year-old football player presents to the emergency department with the acute onset of left upper quadrant abdominal pain, nausea, vomiting, and tachycardia after being tackled during a game. His medical history reveals he had mononucleosis 1 month ago. What is the most likely explanation for these findings? Tested Concept QID: 3029 Type & Select Correct Answer 1 Fractured kidney 0% (5/2921) 2 Ruptured appendicitis 0% (3/2921) 3 Ruptured gallbladder 0% (9/2921) 4 Splenic rupture 99% (2897/2921) 5 Pneumothorax 0% (1/2921) L 1 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review tested concept (SBQ07SM.24) A high school hockey player develops diffuse abdominal pain accompanied by nausea and vomiting after a typical body check into the boards. A CT scan shows a ruptured spleen. Which of the following is a recognized risk factor for splenic rupture in this patient? Tested Concept QID: 1409 Type & Select Correct Answer 1 Regular creatine usage 10% (236/2388) 2 Sustaining a spider bite 1% (27/2388) 3 Drinking alcohol 4% (86/2388) 4 Sharing water-bottles with teammates 84% (1995/2388) 5 Taking NSAIDS on an empty stomach 1% (31/2388) L 2 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review tested concept
All Videos (1) Podcasts (0) Login to View Community Videos Login to View Community Videos Sport Medicine Board Prep Video Collection Series Visceral Blunt Trauma - Dr. Christian Schupp Christian Schupp Knee & Sports - Visceral Blunt Trauma B 9/30/2013 342 views 4.0 (1)