Lec 4 abdominal trauma

The abdomen can be arbitrarily divided into 4 areas.

The first is the intrathoracic abdomen, which is the portion of the upper abdomen that lies beneath the rib cage. Its contents include the diaphragm, liver, spleen, and stomach. The rib cage makes this area inaccessible to palpation and complete examination.
The second is the pelvic abdomen, which is defined by the bony pelvis. Its contents include the urinary bladder, urethra, rectum, small intestine, and, in females, ovaries, fallopian tubes, and uterus. Injury to these structures may be extraperitoneal in nature and therefore difficult to diagnose.
The third is the retroperitoneal abdomen, which contains the kidneys, ureters, pancreas, aorta, and vena cava.
Injuries to these structures are very difficult to diagnose on the basis of physical examination findings. Evaluation of the structures in this region may require computed tomography (CT) scanning, angiography, and intravenous pyelography (IVP).
The fourth is the true abdomen, which contains the small and large intestines, the uterus (if gravid), and the bladder (when distended).
Perforation of these organs is associated with significant physical findings and usually manifests with pain and tenderness from peritonitis.