Dawaa Reference

chronic

Digestive system injury

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Blunt Abdominal Trauma - StatPearls (NCBI Bookshelf NBK431087) - https://www.ncbi.nlm.nih.gov/books/NBK431087/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD35 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (2)

  • The picture is rarely straightforward, so the diagnosis is difficult and takes time
  • Beyond pain, the patient may be bleeding from the back passage [rectal bleeding]

Signs — what you find (5)

  • Unstable observations, and the signs of peritonitis
  • Look for seat-belt marks across the abdomen and for bruising [bruising]
  • A distended abdomen, silent bowel sounds, and tenderness on pressing [abdominal distension]
  • With peritonitis the abdomen goes rigid, with guarding and rebound tenderness [guarding · rebound tenderness]
  • Bruising around the navel, the Cullen sign, means blood tracking forward from behind the peritoneum [bruising]

Tests (12)

  • Take the mechanism, the vehicle speed, deaths at the scene, and alcohol or drug use into account, or an injury will be missed
  • Start as with any trauma: airway, breathing, circulation
  • Which test to use turns mainly on whether the circulation is holding up
  • If the circulation is stable, CT of abdomen and pelvis is the test of choice for solid organ injury
  • If unstable, use bedside ultrasound or peritoneal lavage, both of which miss injuries and also mislead
  • Trauma ultrasound is for blunt or penetrating torso injury with suspected bleeding into the belly, tamponade or blood in the chest
  • Right upper quadrant view: free fluid in the space between liver and kidney, the lower kidney pole, and under the diaphragm
  • Lying flat, the liver-kidney space is the lowest point, and blood runs there along the right gutter
  • Left upper quadrant view: see the whole spleen and the diaphragm, and look above it for fluid in the left chest
  • On the left, fluid gathers under the diaphragm rather than beside the kidney, and gas can hide that area
  • Pelvic view: fluid collects behind the bladder in men and in the pouch of Douglas in women
  • Lung view: no sliding and no comet-tail artefact means a pneumothorax

If not this — what else fits (7)

  • Domestic violence as the mechanism behind the injury
  • Bleeding stroke
  • Shock from blood or fluid loss
  • Injury to the lower urinary or genital tract
  • A penetrating rather than blunt abdominal injury
  • Trauma in a pregnant woman
  • Injury to the kidneys or upper urinary tract

SourceStatPearls "Blunt Abdominal Trauma" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

Spans minor injuries a GP can manage directly (bitten tongue, chipped/knocked tooth) to blunt or penetrating abdominal organ injury that is a surgical emergency; GP gives analgesia and wound care for minor injury and recognises which cases need immediate emergency referral. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Spans minor injuries a GP can manage directly (bitten tongue, chipped/knocked tooth) to blunt or penetrating abdominal organ injury that is a surgical emergency; GP gives analgesia and wound care for minor injury and recognises which cases need immediate emergency referral.

Cautions
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - A rigid or distended abdomen, signs of peritonitis, hemodynamic instability, a penetrating abdominal wound, or expanding bruising or hematoma: refer immediately.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.