Other Organs

The hollow organs, vascular structures and genito-urinary (GU) tract can also be injured and will each display their own characteristic responses to injury.

Fig 1 Onset of peritonitis

Hollow viscus

• Peritoneal contamination with bowel contents will produce peritonism.
• There may be accompanying blood loss but the degree of hypovolaemia is generally less significant than in solid organ injury.
• Damage to the retroperitoneal portion of the bowel will not produce classical signs of peritonism as the leak will be contained.

Vascular structures

• Catastrophic blood loss may occur with injury to any of the large vessels in the abdomen.
• Aortic injury is usually fatal, but may be tamponaded if it occurs retroperitoneally.
• Injury to the inferior vena cava is likely to be associated with more insidious blood loss unless there is a large tear.

GU tract

• Bruising, haematuria or meatal blood are often the only signs of a GU injury.
• Injury to the intraperitoneal portion of the bladder may result in chemical peritonitis.