Abdominal Trauma - Washington Manual of Surgery

Let’s talk abdominal trauma—Join Dr. Kerry Swanson for a discussion with expert critical care surgeon, Dr. Doug Schuerer. This episode of the Washington Manual of Surgery Podcast will focus on care in the ICU and is a companion to Chapter 8 of the 9th edition of the bestselling Washington Manual of Surgery.

In this episode of the Washington Manual of Surgery podcast, Dr. Schuerer, a trauma and acute care surgeon at Washington University in Saint Louis, discusses the management of abdominal trauma. Key topics include the primary and secondary survey of trauma patients, the significance of imaging for gunshot wounds, damage control laparotomy, and the importance of hemostasis. Dr. Schuerer provides insights into modern resuscitation techniques, the use of FAST exams, and the importance of systematic approaches during surgery. 

Guest Host: Kerry Swanson, MD – General surgery resident at WashU Medicine.

Guest: Douglas Schuerer, MD – Director of Trauma at Barnes Jewish Hospital. He is a specialist in Acute Care Surgery. His expertise is in managing critically ill and injured patients.

Notes: 

MTP: massive transfusion protocol (whole blood or 1:1:1 transfusion ratio of packed red blood cells:plasma:platelets). Refers to the administration of balanced blood product ratios, which aims to reduce mortality and improve patient outcomes suffering life-threatening hemorrhages. 

FAST: An acronym for the phrase Focused Assessment with Sonography in Trauma. Refers to rapid bedside ultrasound examination to evaluate a patient’s condition who has experienced abdominal blunt force trauma or penetrating trauma. 

Splenic injuries grading scale: A grading system to determine the level of splenic injury. This five-level scale guides the management and treatment decisions for patients with splenic trauma, Grade I being the least severe and Grade V being the most severe. 

Pringle maneuver: A surgical technique designed for controlling bleeding from the liver through cross-clamping the hepatoduodenal ligament, which includes the hepatic artery, portal vein and common bile duct; only a temporizing measure due to the hepatobiliary ischemia caused by the procedure. 

Zones of the retroperitoneum (RP Zones): Three zones of the retroperitoneum, which surgeons use to describe the locations of injuries or pathology in the retroperitoneal region, identified as:  Zone 1 (sometimes known as the central zone) is the midline retroperitoneum from aortic hiatus to the sacral promontory including the major vessels and their major branches; Zone 2 (sometimes known as the perirenal zone) is the bilateral lateral areas involving the kidneys and their vessels as well as the paracolic gutters; and Zone 3 (sometimes known as the pelvic zone) is the pelvis below the promontory including the iliac vessels. 

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The Washington Manual of Surgery Podcast is a companion to the Washington Manual of Surgery (9th Edition). For more comprehensive surgical education, pick up a copy of the Washington Manual of Surgery: https://bit.ly/41xJ0aQ

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