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