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ZENODO
Article . 2026
License: CC BY
Data sources: ZENODO
ZENODO
Article . 2026
License: CC BY
Data sources: Datacite
ZENODO
Article . 2026
License: CC BY
Data sources: Datacite
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Blunt Abdominal Trauma in the Emergency Department: Initial Evaluation and Evidence-Based Surgical Decision-Making

Authors: Diana Patricia Vargas Víquez; Esteban García Prado; María Gabriela Arroyo Salas; Kevin José Salazar López; Stefanny Nikole Trejos Castro; Fernando Rodríguez Flores;

Blunt Abdominal Trauma in the Emergency Department: Initial Evaluation and Evidence-Based Surgical Decision-Making

Abstract

Blunt abdominal trauma is a frequent and potentially lethal condition in emergency medicine, associated with substantial morbidity and mortality worldwide. It occurs in up to one third of severely injured patients, with the liver and spleen being the most commonly affected organs. Motor vehicle collisions remain the predominant mechanism, followed by falls, pedestrian trauma, assaults, and sports-related injuries. The biomechanical forces involved, particularly deceleration, compression, and crush injury, determine the resulting organ damage and should guide early diagnostic suspicion. Hemorrhage is the most critical immediate consequence, while hollow viscus and mesenteric injuries carry high mortality when diagnosis is delayed. Initial emergency assessment must follow the ABCDE trauma framework, integrating airway, breathing, circulation, neurologic status, and exposure rather than focusing on the abdomen in isolation. Hemodynamic instability is the central factor guiding management: unstable patients with positive FAST findings require urgent laparotomy, whereas stable patients should undergo contrast-enhanced computed tomography for detailed lesion characterization. Clinical examination and laboratory studies remain important but are insufficient alone, particularly because abdominal findings may be subtle or absent in patients with altered mental status, polytrauma, or delayed injury presentation. Repeated examination, serial laboratory assessment, and repeat imaging when indicated are therefore essential. Management decisions depend on physiologic status, injury pattern, and institutional resources. Non-operative treatment has expanded considerably for splenic, hepatic, and selected renal injuries, supported by imaging surveillance and angioembolization. In contrast, bowel, mesenteric, pancreatic, diaphragmatic, and intraperitoneal bladder injuries more often require surgery. Overall, modern care emphasizes early recognition, balanced resuscitation, selective organ-preserving strategies, and timely operative intervention when instability, peritonitis, or ongoing hemorrhage are present.

Keywords

Blunt abdominal trauma, Emergency department, Hemodynamic instability, Computed tomography, Focused Assessment with Sonography for Trauma, Non-operative management.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average