In general, renal vascular injuries occur in less than 5% of blunt abdominal trauma, while isolated. Abdominal and genitourinary trauma authorstream presentation. Chapter 6 abdominal and genitourinary trauma youtube. Methods this retrospective study evaluated patients requiring emergency surgery for abdominal trauma at a level 1 trauma center over 30 years 19802010. Penetrating injuries include gunshot and shrapnel injuries, impalements, and knifings. The patient is unstable and is experiencing obvious signs and symptoms. Ppt abdominal trauma powerpoint presentation free to. Penetrating genitourinary trauma has a more straightforward imaging approach than blunt trauma. A free powerpoint ppt presentation displayed as a flash slide show on id. 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. You are transporting a patient with blunt abdominal trauma. Genitourinary trauma knowledge for medical students and. Injury to this may cause spilling of abdominal contents into the thoracic cavity.
In europe, blunt abdominal trauma accounts for the majority of remaining. Abdominal trauma is responsible for about 10% of all deaths related to trama. Abdominal and genitourinary trauma abdominal and genitourinary trauma steve lan. 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. 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. 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. Start studying chapter 36 abdominal and genitourinary trauma. Chapter 30 abdominal and genitourinary injuries send article as pdf. Cureus impact of genitourinary injuries on patients. Urinary system injuries occur in approximately 4% of trauma. Injuries to the abdomen that go unrecognized or are not repaired in. The urethral meatus should be examined after trauma. The kidney is the third most common abdominal organ to be injured in trauma, following.
Pelvic vein disruption can lead to life threatening hemorrhage. Chapter 11 genitourinary injuries test questions strac. 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. None none abdominal compartment syndrome splenic injury pediatric trauma renal trauma. Abdominal trauma blunt unstable evisceration peritonitis stable unstable stable fluid in okabdomen no fluid concern. Contrastenhanced ct is the primary imaging technique used to evaluate the upper and lower urinary tract for trauma. The diagnosis of genitourinary trauma typically relies on patient history, physical examination, urinalysis, and imaging ct, cystoscopy, retrograde urethrogram. In these cases, additional imaging studies to assess for genitourinary injury occur later, outside of the emergency department. These patient presentations can range from subtle injuries all the way to gross. Chapter 35 abdominal and genitourinary trauma emt i 101. The gu system is divided into three regions, each with its own pattern of injury. Mohamed shafikurology department alexandria university 2. Timely identification and management of genitourinary injuries can minimize the associated morbidity, which may include impairment of urinary continence and sexual function.
Other injuries often take priority over injuries to the genitourinary gu system and may initially interfere or postpone a complete urologic assessment. Damage to the kidney represents the most common type of urinary tract injury. Bladder and urethral injuries are suggested by pelvic fractures. Study 5 chapter 35 abdominal and genitourinary trauma flashcards from shelby g. In many cases, laparotomy may be needed to assess for other abdominal and pelvic injuries. Associated genitourinary trauma is seen in 1112% of pelvic fractures. The role of interventional radiology in urologic tract trauma. Genitourinary trauma, kidney trauma, abdominal trauma, emergency nursing, renal trauma, ureter trauma, bladder trauma, urethral trauma. Three mechanisms of injury exist blunt, penetrating and blast. Timely identification and management of blunt genitourinary injuries. In children with genitourinary tract trauma, renal parenchymal lesions are the most prevalent injuries.
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. Few surgeons have extensive experience with massive abdominal solid organ injury requiring immediate surgery. See initial management of trauma in adults and initial evaluation and management of blunt abdominal trauma in adults and pelvic trauma. 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. Genitourinary trauma involves injury to the kidneys, ureters, bladder, andor urethra.
Genitourinary trauma, kidney trauma, abdominal trauma, emergency nursing, renal trauma, ureter trauma, bladder trauma. 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. Blast phase caused solely by the direct effect of overpressure. Blunt and penetrating abdominal trauma can cause significant injury to the genitourinary organs, and radiologic imaging plays a critical role both in diagnosing. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Knowledge of genitourinary system anatomy is essential to evaluating and treating traumatic urologic injuries. Abdominal, suprapubic, flank or back pain or tenderness scrotal or groin pain genital sores, swelling, discolouration. Renal injuriesrenal injuries ureteral injuries bladder injury urethral injuries 3. Chapter genitourinary system first nations and inuit health branch fnihb pediatric clinical practice guidelines for nurses in primary care. Renal injuries are suggested by lower rib fractures. This episode of crackcast covers rosens chapter 047, genitourinary trauma.
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. Discuss the types of traumatic injuries sustained by the male and female genitourinary system. Given the increasing alacrity and accuracy of ct angiography in the evaluation of abdominal trauma. Started in 1995, this collection now contains 6769 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Demonstrate how to apply a dressing to an abdominal evisceration wound. Renal trauma is most often an acute condition caused by a blunt abdominal. Abdominal and genitourinary trauma unit flashcards quizlet. Blunt abdominal trauma affects the liver and the spleen more often than the kidney.
Our colleagues in adult trauma care have slowly acknowledged this success and applied many of the principles learned in pediatric trauma to their patients. 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. Neurologic injuries including spinal cord injury, chest and abdominal injuries, head injuries and extremity injuries can be associated with pelvic fractures. Special attention was given to patients with concomitant genitourinary gu injuries. The lower tract consists of the bladder and the posterior portion of the urethra. 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. Overview of genitourinary trauma society of urologic nurses. Following principles of vascular injury in the retroperitoneum, all zone 2 perinephric. Contains organs that make up digestive, urinary, and genitourinary systems. Chapter 36 abdominal and genitourinary trauma flashcards. Chapter 47 genitourinary trauma episode overview 1. The presence of tachycardia following a significant abdominal injury. Abdominal and genitourinary trauma recognition and.
Because trauma is a multisystem disease, multiple injuries may be present in the trauma patient. Rupture of this organ leads to spilling of acidic material. Genitourinary trauma an overview sciencedirect topics. Chapter 35 abdominal and genitourinary trauma yellow quiz or. Explain assessment of a patient who has experienced an abdominal injury. Describe some special considerations related to the care of pediatric patients and geriatric patients who have experienced abdominal trauma. It may result in high morbidity if not properly identified and managed. Start studying abdominal and genitourinary trauma unit.
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. Introduction in patients having emergency abdominal surgery for trauma, the presence of urologic injury tends to increase mortality and morbidity. Flank abdominal rib back pelvic scrotal pain worry in cases of pelvic. In the majority of instances, injury results from blunt impact following a road traffic accident. Abdominal trauma may involve penetrating or blunt injuries. Blood in the urine after abdominal trauma suggests a urinary tract injury. Applies fundamental knowledge to provide basic emergency care and transportation based on assessment findings for an acutely injured patient. A high index of suspicion is mandatory in potential abdominal trauma as signs and symptoms may be subtle or evolve slowly. Although both penetrating and blunt injuries are common, blunt abdominal trauma is the leading cause of death and disability across all. The majority of these injuries approximately 80% are the result of a blunt trauma mechanism. Blunt lower abdominal trauma with a distended bladder the blunt forces stretch the weaker dome of the bladder.
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