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Trauma · Chapter 24 Not started
Abdominal and Pelvic Trauma
The quiet compartment: recognizing internal bleeding and handling pelvic fractures gently.
Key points
- The abdomen can hide massive hemorrhage with subtle signs: pain, guarding, rigidity, bruising patterns, and unexplained shock.
- Handlebar-style and pole-plant impacts, tree wells, and terrain-park landings drive solid-organ injuries (spleen, liver).
- Left-shoulder pain after abdominal impact (Kehr's sign) can indicate spleen injury with diaphragmatic irritation.
- Eviscerated organs: cover with a moist sterile dressing, then an occlusive layer — never push them back in.
- Suspected pelvic fracture: compress once gently to assess (if at all, per protocol), stabilize with a pelvic binder or improvised wrap, and treat aggressively for shock — the pelvis can bleed liters.
- Unexplained shock after torso trauma = internal bleeding until proven otherwise; rapid transport.
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