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Blast abdominal injury — RCPSC EM MCQ

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HardTraumaBlast abdominal injuryRCPSC EM

A 24-year-old soldier is evaluated after a blast exposure. He has bilateral tympanic membrane rupture, abdominal pain, vomiting, and mild hypotension. Chest radiograph is normal, lactate is 4.1 mmol/L, and abdominal exam is diffusely tender. What is the most appropriate investigation?

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Correct answer: C — CT abdomen and pelvis with contrast

Blast bowel injury can occur despite a normal chest radiograph, particularly with abdominal pain, vomiting, hypotension, and raised lactate. CT is indicated in a stable enough patient.

Reference: ATLS blast injury principles; Canadian trauma practice