Abdominal trauma is any blunt or penetrating injury that damages structures within the abdominal cavity. Clinical pictures range from subtle discomfort to life-threatening hemorrhage or peritonitis; key pointers are listed below.
- Abdominal pain and tenderness
Pain is present in almost every case, but its intensity can mislead: severe organ injury may cause only mild ache, while apparently trivial wounds sometimes produce marked discomfort. Localized tenderness on palpation, guarding, or rebound pain suggests peritoneal irritation . - External marks
Bruises, abrasions, seat-belt imprints, stab wounds or bullet holes over the abdomen, flank or back provide visible evidence of impact and raise suspicion for deeper damage . - Swelling and distension
Progressive abdominal distension may indicate accumulating blood, bile, urine or intestinal contents. A rigid, board-like abdomen implies significant intraperitoneal bleeding or spillage of enteric contents . - Shoulder-tip pain
Irritation of the diaphragm by free blood or fluid can produce referred pain at the tip of either shoulder, especially when the patient lies supine . - Hypovolaemic and haemorrhagic signs
Tachycardia, hypotension, cool peripheries, pallor and narrowing pulse pressure follow major solid-organ (spleen, liver, major vessel) laceration. Delayed shock may appear hours after the initial event as contained haematomas rupture . - Gastro-intestinal symptoms
Nausea, vomiting and absent bowel sounds are common with bowel perforation or mesenteric injury. Subsequent fever and leukocytosis herald peritonitis. - Urinary changes
Haematuria, flank pain or inability to void suggests renal, ureteric or bladder trauma. Penetrating wounds at any level between the nipples and the perineum can injure intra-abdominal organs. - Neurological overlay
Head injury, intoxication or distracting fractures may mask abdominal findings; repeated examination is mandatory.
Because clinical signs can be subtle in the early phase, any patient with a suggestive mechanism plus pain, tenderness or unexplained hypotension requires urgent imaging and surgical review.
| Symptom / Sign | Typical Meaning |
|---|---|
| Abdominal pain ± guarding | Peritoneal irritation, organ injury |
| Bruises, seat-belt sign | External evidence of force |
| Distension / rigidity | Haemoperitoneum, bowel spillage |
| Shoulder-tip pain | Diaphragmatic irritation from free fluid |
| Tachycardia, hypotension | Significant haemorrhage |
| Nausea, vomiting, ileus | Bowel or mesenteric damage |
| Haematuria / flank pain | Genito-urinary tract injury |
| Delayed shock | Expanding or ruptured haematoma |