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Trauma
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Blunt Abdominal Trauma
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Unstable + free fluid = OR. Stable = CT.
Decision
Outcome
Decision
Blunt abdominal trauma. Hemodynamic status?
✓
Unstable
✓
Stable
Decision
Unstable — peritonitis?
✓
Yes → laparotomy
✓
No → eFAST
Outcome
Laparotomy
Damage control if coagulopathic, hypothermic, acidotic.
Decision
Unstable + eFAST result?
✓
Free fluid → laparotomy
✓
Negative or inconclusive → CT abdomen/pelvis after resuscitation, or DPL; look for other bleeding source
Outcome
CT scan of abdomen/pelvis with IV contrast; manage findings non-operatively if stable solid-organ injury
Splenic and liver injuries are often managed non-operatively with serial Hb checks.
Decision
Stable — peritonitis?
✓
Yes → laparotomy en route
✓
No → eFAST
Decision
Stable + eFAST?
✓
Free fluid → CT abdomen/pelvis
✓
Negative → CT or serial exams based on injury suspicion
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