Acute blast injury can cause injury to intra-abdominal organs, especially the intestines. The presence of abdominal signs and symptoms should prompt a more careful examination for possible occult injuries.


Types of intra-abdominal injury in acute blast injury:

(1) gastrointestinal hemorrhage

(2) perforation of esophagus, stomach, small bowel, colon or rectum

(3) hepatic or splenic rupture

(4) retroperitoneal hemorrhage


Clinical signs and symptoms of primary blast injury of the abdomen:

(1) absent bowel sounds

(2) tenesmus (painful and ineffective straining when defecating)

(3) bright red blood per rectum

(4) hypotension or shock

(5) syncope

(6) involuntary guarding

(7) rebound tenderness

(8) abdominal pain

(9) nausea and vomiting

(10) testicular pain

(11) intraperitoneal blood (by diagnostic peritoneal lavage, FAST, or CT scan)

(12) black, tarry stools (if delayed presentation and upper abdominal bleeding)


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