![]() ![]() A sudden and pronounced rise in intra-abdominal pressure created by outward forces can rupture a hollow viscus. MECHANISM OF INJURY - Several pathophysiologic mechanisms can occur in patients with blunt abdominal trauma (BAT). Patients presenting with signs of BAT from seatbelts are at relatively higher risk for hollow viscus injury, although the overall risk of injury is low. Injuries to the pancreas, bowel and mesentery, bladder, and diaphragm, as well as retroperitoneal structures (kidneys, abdominal aorta), are less common but must be considered. The spleen and liver are the most commonly injured solid organs. The prevalence of intra-abdominal injury among patients presenting to the ED with BAT is approximately 13 percent. (See "Physical child abuse: Diagnostic evaluation and management".) Occult BAT may occur with child abuse and domestic violence. Blows to the abdomen and falls are responsible for 15 and 6 to 9 percent, respectively. The majority of BAT cases (75 percent) are related to motor vehicle collision or auto versus pedestrian accidents.
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