DR. GRANT FOWLER: So how do we manage abdominal trauma and when do you need to seek help and what kind of things to be worried about with abdominal trauma? In contact--the main abdominal trauma you are going to see in sports medicine is in contact sports. Not that much different than what you see in automobile accidents. And there has been kind of a highly technical ability to change in technology to manage abdominal trauma in the emergency department, but the question is when do you need to see the emergency physician or something like that. Significant--enough abdominal trauma to the abdomen to cause you to pass out, you probably should be seen in an emergency department, probably very soon, almost urgently if not immediately, so enough trauma to cause something like that. Enough trauma to cause significant bruising on the abdomen would be a time that you really need to be seen by a physician pretty fast. Other warnings signs, if a day later or the next day, dizziness, wooziness, any indication that you are having a drop in your blood pressure would be a time to urgently see a physician. What kind of things can happen? You worry with abdominal trauma that you've damaged your internal organs and the vulnerable area would be mainly the abdomen. You certainly could have enough trauma to the chest to be a problem. But the abdomen is not protected by a hard skeleton, so the organs that are vulnerable are things like your spleen, your liver and your kidney. Even your bladder can actually be involved with that, too. And we used to see in and when they used to use helmets in football for spearing, we've seen ruptured spleens on a regular basis. So it takes a significant amount of abdominal trauma to damage or crack or even fracture an internal abdominal organ, but it can happen with contact sports. Delayed things to watch for, blood in your urine would obviously be a problem; dizziness, if you feel like you are going to pass out or faint the next few days; problems with your blood pressure or low blood pressure that would not be expected otherwise, or urgently if that happens right on the scene at the time of the contact sport. Typically, someone on the sidelines or someone in the stands, specifically the coach and/or trainer, will have observed the nature of the trauma. And they are usually very good about assessing right at the time and right after the moment of the injury the vital organs by exam. There are a lot of things you can do by just examining the belly. Any time the abdomen becomes hard or rigid or there is significant pain in the area that you are examining, we would worry about that you have damaged one of those organs. And that would probably be a time that you need to be seen urgently in an emergency department or in a doctor's office. But not to forget the delayed symptoms: blood in your urine, feeling like you are going to pass out, not able to eat, significant nausea, vomiting. After abdominal trauma, you could have injured some of your internal organs. That would be the time to seek medical care. And that is our summary of abdominal trauma.
