Penetrating Abdominal Injury

What is a penetrating abdominal injury?

A penetrating, or piercing, abdominal injury may tear, puncture, or damage an organ. These injuries are caused by an object that penetrates the skin, such as a gunshot or stab wound. They may also be caused by broken bones, shrapnel, or other pointed objects. Your pancreas, liver, spleen, kidneys, or bladder may be injured. These injuries may cause internal bleeding.

What are the signs and symptoms of a penetrating abdominal injury?

  • An open wound that may be bleeding

  • Abdominal pain, redness, and swelling

  • Bruises, swelling, or scratches on the abdomen

  • Nausea or vomiting

  • Blood in your urine

  • Trouble urinating or passing little to no urine

  • Signs of shock, such as a fast heartbeat, dizziness, and pale skin

How is a penetrating abdominal injury diagnosed?

Your healthcare provider will examine you. You may need tests that require contrast dye. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body. You may need any of the following:

  • Blood and urine tests may show how your organs are working and if you have internal bleeding.

  • An x-ray, ultrasound, CT, or MRI may show the injury and any damage to the surrounding tissues or organs.

  • An angiography may show problems with blood flow in your abdomen. A catheter is placed in a blood vessel in your groin. Dye is inserted. Pictures are taken using an x-ray or a CT scan after the dye goes to your abdominal organs.

  • A cystogram is a type of x-ray that shows your bladder. A catheter is put into your bladder and dye is inserted. X-rays are taken to look for damage or how much urine is in your bladder.

  • An endoscopic retrograde cholangiopancreatography (ERCP) may show damage to your pancreas and gallbladder. Contrast dye may be used to show your organs clearly.

  • Peritoneal lavage may show if you have internal bleeding. A catheter and needle are inserted through an incision in your abdomen. Liquid is put into the catheter. Fluid is then removed and checked for signs of blood or bile.

How is penetrating abdominal injury treated?

Your healthcare provider will watch you closely to see if your injury is mild and your condition is stable. You may need any of the following:

  • Medicines:

    • Antibiotics help prevent or treat a bacterial infection.

    • Prescription pain medicine may be given. Ask how to take this medicine safely.

    • A Tetanus vaccine is a booster shot used to help prevent tetanus. The booster may be given to adolescents and adults every 10 years or for certain wounds and injuries.

  • A drain may be placed to remove extra blood or fluid from your abdomen.

  • Embolization is a procedure to stop internal bleeding. A liquid, coil, or gel is injected into a blood vessel.

  • Surgery may be needed to look for and repair bleeding or damaged organs. Ask for more information about the type of surgery you need.

How can I manage my symptoms?

  • Rest when you feel it is needed. Slowly start to do more each day. Return to your daily activities as directed.

  • Care for your wound as directed. You may need to carefully wash the wound with soap and water. Dry the area and put on new, clean bandages as directed. Change your bandages when they get wet or dirty.

When should I contact my healthcare provider?

  • You have a fever.

  • Your wound is red, swollen, and draining pus.

  • Your pain does not go away, or it gets worse, even after treatment.

  • You feel dizzy or are vomiting.

  • You have trouble urinating.

  • You have blood in your urine.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You feel lightheaded, short of breath, and have chest pain.

  • You cough up blood.

  • You have a fast heartbeat.

  • You have severe pain in your abdomen.

  • Your abdomen is more swollen and firm.

  • You are urinating little or none at all.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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