What to Do for a Blow to the Abdomen, According to a Doctor

Children and adults alike can often end up in the emergency room following a blow to the abdomen, as they worry about any possible damage to internal organs.

While motor vehicle accidents top the list of causes for abdominal injury in the United States, according to StatPearls, other factors such as direct blows, assaults and sports injuries can also trigger such trauma. Being with someone who sustains a blow to their stomach can be alarming, leaving you unsure of the proper actions to take.

In this article, you will get expert guidance from Dr. Jim Keany, co-director of the emergency department at Providence Mission Hospital in Orange County, Calif.

Serious injuries to the abdomen

Blunt force trauma to the abdomen, such as being kicked in the stomach, can result in severe injuries. Here are some examples of the types of abdominal injuries caused by sports, according to Stanford Medicine. However, it is important to know these same types of abdominal injuries can result from direct blows, assaults and car accidents:

• Kidney trauma: This can lead to flank pain and blood in the urine.
• Spleen damage: This type of injury causes discomfort on the upper left side of the abdomen. The spleen, responsible for filtering nearly 10% of the body's blood supply per minute, can lead to rapid and life-threatening internal bleeding if torn.
• Liver harm: This results in pain on the upper right side of the abdomen. The right lobe of the liver, being larger and pressing against the ribcage, is more susceptible to injury. A torn liver may cause severe bleeding, albeit less frequently than a torn spleen.
• Abdominal injuries: These can affect various organs like the pancreas, diaphragm, stomach, gallbladder, bladder or intestines. Any organ within the abdomen can be affected singly or in combination.

According to Keany, “abdominal injuries and their severity are subject to the inertia involved. Think of the sport of polo, where one of the players is a horse. A horse obviously has more body mass than a human, and it’s faster. If a horse and human collide, the human will likely be injured and the results can be serious."

What to look out for

StatPearls says that in serious cases of abdominal trauma, especially in the case of car accidents, the patient can also present with bleeding from the rectum, unstable vital signs and the presence of peritonitis (swelling and inflammation). A physical exam by a paramedic or in the emergency room may reveal marks from a lap belt, bruising, abdominal distention, absent bowel sounds (indicating no movement) and tenderness to palpation.

“In the case of a car accident, you’ll likely be attended to by a paramedic or emergency personnel. In that case, follow the instructions you are given and go to the emergency room if you are directed to do so,” Keany said. “However, in non-motor vehicle-related incidents, use your best judgment based on the circumstances. For a healthy person, if they are feeling fine and there is no pain, there is no need to go to the emergency room. Monitor the situation and if you start to feel pain later, then the chances are you need to be seen at that time.”

However, Keany added that if the abdominal trauma is related to a pregnant woman, then the situation may be handled differently. “During the first seven months of the pregnancy, the baby is protected by a lot of water. So if she is hit and not feeling any discomfort, the chances are that she is fine. But, a call to her obstetrician is never a bad idea. However, if the incident occurs during the third trimester and it is a significant blow, she should get checked out,” he advised.

Further, the Cleveland Clinic shares that if there is sign of shock, it may mean something more serious. Hypovolemic shock occurs due to significant blood or fluid loss, which can result from either internal bleeding or external injuries with visible bleeding. Symptoms can include:

• Breathing faster than normal
• Feeling confused or anxious
• Sweating a lot
• Passing out
• Having skin that feels cool
• Feeling weak
• Having a low temperature and low blood pressure
• Having a fast pulse

Recognizing the signs and seeking immediate medical attention is crucial to prevent the severe consequences associated with this condition.

What to do until help arrives

If someone experiences abdominal trauma and they are experiencing pain, it is crucial to act swiftly until medical help arrives:

• Call for help: Dial 911 immediately to seek professional assistance
• Keep the person still: Encourage them to lie down and avoid unnecessary movements
• Apply pressure: If there's an open wound, gently apply pressure with a clean cloth to control bleeding
• Monitor breathing: Keep an eye on their breathing and stay prepared to perform CPR if needed
• Don't offer food or drink: Avoid giving anything to eat or drink to prevent making their condition worse

By following these steps, you can help stabilize the person until professional medical aid arrives.

“If the person has a ruptured organ that is releasing blood, they will develop a rigid abdomen within about an hour. Have the person lay on their back, bend their knees, and place your hand on their belly and press down. If the belly is soft and they are not experiencing pain, there is generally no cause for alarm. However, if the belly is hard and they are showing pain, they need to seek medical attention,” Keany said.

Minor injuries to the abdomen

“Whether or not an injury is going to be major or minor goes back to the concept of inertia, which is a combination of weight and speed. Think of an accident involving a cement truck going 5 mph. This will likely do just as much damage as a standard vehicle going 30 mph,” Keany explained.

“Consider the inertia of what you have been hit with. If you or the person you are with are hit with something small like a small utensil, it won’t cause damage," he said. "Assess the situation and use your common sense. If there is potential for serious injury, knowing that symptoms can be delayed, you should probably be checked." That said, the inertia involved in the incident and the type of incident determine whether an abdominal injury is minor or more severe. WakeMed lists the following common minor abdominal injuries:

• Abrasions or lacerations (scrapes and cuts)
• Contusions or hematomas (bruises)
• Rupture or perforation (severe tearing of the tissue)

What to look out for

“Pay attention to signs of pain,” Keany said. “Pain is the most obvious symptom. If the person is lacking pain and has a normal ability to sense pain, then consider that the number one factor.”

“When it comes to kids, pay attention to their behavior after the injury. If they are running around, playing and jumping, they are likely fine," he said. "When a child with a potential abdominal injury comes into the ER, I push on their stomach, ask them to do jumping jacks, etc., to see how they respond.”

How to help

If a person you are with has been kicked in the stomach or has experienced some sort of blow to the abdomen, the first thing to do is keep calm. Provided that the person is in relatively good health and can communicate their level of pain and how they are feeling, the best thing to do is “use your best judgment and look for signs of pain. If there is no pain, the chances are they may be sore, but will be fine,” he added.

SOURCE: Jim Keany, MD, co-director, emergency department, Providence Mission Hospital, Orange County, Calif.