What are the key signs and symptoms that indicate the need for urgent intervention in abdominal trauma cases?

Key signs and symptoms indicating the need for urgent intervention in abdominal trauma include:

• Haemodynamic instability, such as hypotension or shock, which suggests ongoing internal bleeding requiring immediate resuscitation and possible surgical or interventional radiology control ¹.
• Signs of peritonitis or an acute abdomen, including severe abdominal pain, guarding, rigidity, or rebound tenderness, indicating possible hollow viscus injury or intra-abdominal bleeding (Como et al., 2010).
• Evidence of active or suspected active bleeding, such as expanding abdominal distension, bruising, or external bleeding, necessitating rapid haemorrhage control measures including damage control surgery or interventional radiology ¹.
• Altered level of consciousness or neurological deterioration, which may reflect associated major trauma or shock state requiring urgent airway management and resuscitation ¹.
• Respiratory compromise or severe respiratory distress, which may accompany abdominal trauma and require airway protection and ventilation support ¹.
• Positive findings on focused assessment with sonography for trauma (eFAST) indicating free intra-abdominal fluid or blood, which supports the need for urgent intervention if correlated with clinical instability ¹.
• Failure to respond to initial volume resuscitation, indicating ongoing bleeding or injury severity that mandates damage control surgery or definitive surgical intervention ¹.

In summary, the presence of haemodynamic instability, signs of peritonitis, active bleeding, respiratory compromise, altered consciousness, positive imaging findings, and poor response to resuscitation are critical indicators for urgent intervention in abdominal trauma. These clinical features guide the need for rapid airway management, haemorrhage control, and surgical or radiological intervention to improve outcomes ¹; (Como et al., 2010).