Trauma: Stomach Trauma

Stomach

General

  • Most Common from Penetrating Trauma

AAST Stomach Injury Grade

Diagnosis

  • Dx: Often Seen on CT
  • NG May Show Bloody Aspirate

Traumatic Stomach Perforation 1

Treatment

  • Small Perforation (Grade I-II): Primary Repair (One or Two-Layer)
    • One-Layer: Use Nonabsorbable Suture
    • Two-Layer: Inner Absorbable, Outer Nonabsorbable
  • Large Perforation (Grade III): Primary Repair vs Resection
  • Grade IV: Partial Gastrectomy & Reconstruction
  • Grade V: Total Gastrectomy & Roux-en-Y Esophagojejunostomy
  • *First Step for Anterior Wounds is to Inspect Posterior Surface
    • Incise Gastrocolic Ligament & Enter Lesser Sac

References

  1. Angelopoulos S, Mantzoros I, Kyziridis D, Fontalis A, Parpoudi S, Konstandaras D, Tsalis C. A rare case of a transabdominal impalement after a fall from a ladder. Int J Surg Case Rep. 2016;22:40-3. (License: CC BY-NC-ND-4.0)