Abdominal Vascular Trauma

Abdominal vascular trauma is highly lethal. Many patients with major abdominal vascular injuries die at the scene. The clinical presentation will depend on the injured vessel, the size and type of injury, intraperitoneal or retroperitoneal location, polytrauma, and time since injury. This chapter aims to delineate the latest evidence-based management, treatment, and interventions to use in handling abdominal vascular trauma. Abdominal vascular trauma usually presents as hypotension or expanding hematoma. When blunt traumatic abdominal injury (BTAI) is present, the focused assessment with sonography in trauma (FAST), vitals, mechanism of injury, and physical exam help categorize the severity of the patient's status. For patients arriving at the emergency department in cardiac arrest, a left anterolateral thoracotomy should be performed with aortic cross-clamping and cardiac massage. If a return of spontaneous circulation (ROSC) is obtained, the patient is taken to the operating room (OR) for completion of exploration.