Which secondary survey finding would prompt urgent surgical consultation for suspected hollow viscus injury?

Which secondary survey finding would prompt urgent surgical consultation for suspected hollow viscus injury?

• A. Isolated bruising on the abdomen with no tenderness
• B. Rebound tenderness and guarding with signs of peritonitis
• C. Normal exam without abdominal findings
• D. Absent pain despite imaging

Answer: (B)

Peritoneal signs on the secondary survey indicate an urgent hollow viscus injury. Rebound tenderness and guarding reflect peritonitis, which often results from perforation of a hollow organ or significant intra-abdominal contamination. This is a surgical emergency because delaying exploration can lead to rapid deterioration from sepsis, ongoing leakage, or ongoing bleeding. In trauma care, peritonitis signs trump quiet exams or imaging that do not show peritoneal irritation, because they reveal an ongoing intra‑abdominal catastrophe that requires prompt operative intervention. Isolated bruising, a normal exam, or painless imaging don’t demonstrate the acute intra‑abdominal threat that peritonitis does, so they wouldn’t prompt urgent surgical consultation in this context.

Peritoneal signs on the secondary survey indicate an urgent hollow viscus injury. Rebound tenderness and guarding reflect peritonitis, which often results from perforation of a hollow organ or significant intra-abdominal contamination. This is a surgical emergency because delaying exploration can lead to rapid deterioration from sepsis, ongoing leakage, or ongoing bleeding. In trauma care, peritonitis signs trump quiet exams or imaging that do not show peritoneal irritation, because they reveal an ongoing intra‑abdominal catastrophe that requires prompt operative intervention. Isolated bruising, a normal exam, or painless imaging don’t demonstrate the acute intra‑abdominal threat that peritonitis does, so they wouldn’t prompt urgent surgical consultation in this context.