Management in the ED

Management in the ED involves analgesia and fluid resuscitation.

Access to CT scanning may delay definitive management, particularly in the unstable patient, or be difficult to access with multiple casualties.

FAST scanning may identify free intraperitoneal fluid, although will not be able to distinguish between the different types of blast injury, and may miss a perforated hollow viscus [4,8].

Patients with only mural or mesenteric haematoma should be admitted and managed with bowel rest and nasogastric decompression. They should undergo regular reassessment of abdominal signs [6].

Learning Bite

Patients with abdominal pain following exposure to a blast should be admitted and regularly reassessed.