Penetrating Abdominal Trauma
A 24-year-old male is brought to the emergency room following a gunshot wound (GSW) to the left lower abdomen. On initial examination, his blood pressure is 80/65 mmHg, heart rate is 140/min, and respiratory rate is 26/min. He appears pale and is diaphoretic. He is unable to remain still secondary to pain. The patient’s airway is patent and there are equal breath sounds bilaterally. He has a rigid abdomen with diffuse tenderness, guarding, and rebound. There is a single entry wound to the left lower quadrant. No other GSWs are noted on exam. Palpation of the patient’s lower extremity pulses reveals a diminished left femoral pulse and a normal right femoral pulse. His left leg is cool to touch. The patient is urgently taken to the operating room.
KeywordsPenetrating Abdominal Trauma DPL FAST Laparotomy Massive transfusion protocol Permissive hypotension Nonoperative management Abdominal compartment syndrome
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