VECTORS OF FORCE
• RIGHT SIDED MIDLINE LEFT
RIGHT HEPATIC LOBE LEFT HEPATIC LOBE SPLEEN
RIGHT KIDNEY PANCREATIC BODY LEFT
DIAPHRAGM PANCREATIC HEAD AORTA
DUODENUM TRANSVERSE COLON
HOW TO SCAN
• Patient placed in supine position
• Low frequency curvilinear probe
• Transducer marker
• Longitudinal ---- Towards head
• Transverse – To patient right
FLUID IN PELVIS
• PELVIS : Longitudinally and transverse axis
• Probe placed – transversely than longitudinally
• Midline 2 cm superior to the symphysis pubis
• Aimed –caudally into the pelvis
• Probe facing towards the patients head and right side
• Best with some urine in bladder
• Evaluating : Bladder , uterus in females , Prostate in male
• HEMODYANAMICALLY STABLE
-MILD TO MODERATE RESPONSIVE HYPOTENSION
-SIGNIFICANT TRAUMA AND HAVE AT –LEAST MODERATE SUSPICION OF
INTRABDOMINAL INJURY BASED ON CLINICAL SIGNS AND SYMPTOMS
-THESE PATIENTS SHOULD BE EVALUATED BY IMAGING
• UNSTABLE ---
• INVESTIGATION AVAILIBILITY
--- FAST : FREE FLUID ::--- CONTINUE RESUSCITATION
----DPL --- BLOOD --- YES---- LAPROTOMY
SIGNIFICANT TRAUMA AND HAVE At least moderate suspicion of intra-abdominal
injury based on clinical signs and symptoms .These patients should be evaluated by
MORAVELLE LAVELLE LESSON
Typically these lesions are anechoic or hypoechoic. As with a standard
hematoma, it can be predominantly echogenic in the acute phase, becoming
more hypoechoic as blood products liquefy over time 11. Internal debris,
including fat globules, can give rise to echogenic foci or even fluid-fluid
levels 1. A capsule of variable thickness may be seen. The shape may range
from flat to mass-like.
•lacerations that involve a hepatic vein are associated with increased risk of arterial injury and need
for operative management 8
•although not an injury, periportal edema can be seen associated with liver injuries as patients with
higher-grade injuries will have received aggressive fluid resuscitation
•lacerations that extend to the porta hepatis increase the risk of bile duct injuries, particularly delayed
biliary complications 8
SYMPTOMS OF RIGHT UPPER QUADRANT
•Sudden and rapidly intensifying pain in the upper
right portion of your abdomen.
•Sudden and rapidly intensifying pain in the center
of your abdomen, just below your breastbone.
•Back pain between your shoulder blades.
•Pain in your right shoulder.
•Nausea or vomiting
SYMPTOMS OF BLADDER INJRY
•Lower abdominal pain.
•Bruising at the site of injury.
•Blood in the urine.
•Bloody urethral discharge.
•Difficulty beginning to urinate or inability to empty the bladder.
•Leakage of urine.