Trauma Abdomen
 Biasanya multitrauma

and assaults.Penyebab  Trauma tumpul : falls. 3rd edition)  Trauma tembus -. sporting mishaps. motorcycle or bicycle crashes. Compression causing a crush injury Shearing force causing tears of organs or vascular pedicles Sudden rise in intraabdominal pressure causing rupture of an intraabdominal viscus (Trauma Manual. Luka tembak -. Luka tusuk /impalement .

3rd edition) . (Trauma Manual. and medication or substance effects. spinal cord or other distracting injury.Akibatnya  Syok hipovolemik Shock should be regarded as present if any trauma patient presents with a systolic blood pressure less than 110 mmHg and a heart rate greater than 100 beats/min (Acute Care Surgery 2009)  Peritonitis Abdominal examination after blunt trauma is often unreliable due to altered level of consciousness.

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Resuscitation of Trauma patient .

Resusitasi cairan pada anak  Bolus kristaloid I : 20 cc/kgbb  Bolus kristaloid II :20cc/kgbb  Transfusi PRC/O negatif + FFP + trombosit  Bahaya hipotermi : cairan hangat. selimut hangat. ruangan hangat  Sering terjadi distensi lambung selama resusitasi  pasang NGT .

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FAST .

FAST .

CT abdomen .

Bile  Food particles .000 red blood cells/mm3  >500 white blood cells/mm3  Bacteria.Diagnostic Peritoneal Lavage  Criteria for positive DPL  10 mL gross blood on aspiration  > 100.

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Trauma limpa .

Trauma ginjal .

and <1-L blood loss.  Rectum : intraperitoneal : primary repair extraperitoneal : colostomy . <8-hour delay in diagnosis and treatment. minimal associated intraabdominal injuries. stoma  Usus besar : primary repair if minimal fecal spillage. no shock (defined as systolic blood pressure <90 mmHg).Trauma usus  Gaster : debridement dan suture primer  Usus halus :reseksi anastomosis.

ileum.influenzae.TRAUMA ABDOMEN ANAK  Sering : trauma yeyunum. h. meningococ)  Trauma ginjal : sering . gaster  Trauma limpa : baik dikelola secara non operatif Bila dilakukan splenectomy imunisasi post op (pneumococ.

d ½ volume darah/24jam (40ml/kgbb) . renal dikelola secara non operatif. Pembedahan jika diperlukan darah s. lien. Trauma hepar.

Nonoperative management of blunt hepatic injury .

Trauma. Feliciano . 2008.

coagulopathy.Damage control surgery laparotomy  The damage control sequence is commonly employed to avoid the “lethal triad” of hypothermia (defined as a core body temperature of <35°C). and acidosis. .

Three Step 1. Operating Room (Part I) • Rapid control of hemorrhage • Control or containment of contamination • Restoration of vascular flow when required • Intra-abdominal packing • Temporary abdominal closure .

Intensive Care Unit • Core rewarming • Optimization of hemodynamics • Correction of coagulopathy • Ventilatory support • Secondary survey and injury identification .2.

Operating Room (Part II) • Pack removal • Definitive repair of injuries • Abdominal wall closure .3.