Broken ribs and swollen stomachs are linked with each other. It is an uncommon cause of hollow viscus perforation on its own. A fragment of a cracked rib entered through the diaphragm and perforated the stomach. The patient’s CT scan indicated substantial volumes of bilious free fluid in the abdomen. A significant chunk of a shattered rib protruded through the retroperitoneum below the spleen. The small and big bowels, liver, spleen, pancreas, kidneys, and ureter, were all normal. Pneumothorax and pneumoperitoneum were not discovered on the initial chest x-ray. A shattered rib piece pierced the diaphragm and perforated the stomach.
Broken Ribs Cause Swollen Stomach
Broken ribs have been linked to many intra-abdominal and intrathoracic injuries. It is linked to intra-abdominal solid ■■■■■ damage; however, it is an uncommon cause of hollow viscus perforation on its own. A fragment of a cracked rib entered through the diaphragm and perforated the stomach in the instance of a woman who suffered a violent injury.
Case Report
A 33-year-old lady took to West Cumberland Hospital’s accident and the emergency department after being crushed from behind by a grabber and suffering blunt injuries to her chest and abdomen. She complained of chest and abdominal pain, and she vomited once. She claimed she had no indications of respiratory, cardiovascular, or gastrointestinal illness.
Her pulse and blood pressure were regular, and she was aware, coherent, and hemodynamically stable. Her coma score in Glasgow was 15. Tenderness and subcutaneous emphysema were found in the left lower chest with excellent air entry on both sides.
A cut approximately 5 cm in length was discovered on examination of the abdomen, with discomfort and guarding in the left upper quadrant.
The urine was examined with a Dipstix and found to contain moderate levels of blood. The whole blood count and serum biochemistry were within normal limits. On the left side, a chest x-ray revealed fractures of the eighth and ninth ribs as local subcutaneous emphysema in the soft tissues covering the fractures. There was no pneumo/haemothorax or pneumoperitoneum present.
Scanned the abdomen with computerized tomography (CT) scanner, which revealed normal solid abdominal viscera, an undamaged spleen, and well-perfused kidneys. There was some gas and fluid in the intraperitoneal cavity.
The CT scan revealed rib fractures and emphysema near the splenic flexure, indicating colonic perforation. The stomach was bloated but appeared in good condition. The significant vessels appeared to be in good condition. The lungs had minor posterior atelectasis at the base, but no pneumothorax or considerable pleural effusion was found.
A CT scan revealed a fracture of the left transverse process of the L4 vertebrae, as well as psoas edema and an undamaged vertebral body.
Exploratory laparotomy was conducted in light of the CT scan, which indicated substantial volumes of bilious free fluid in the abdomen. The posterior wall of the stomach’s body had two perforations near together.
A significant chunk of the shattered rib protruded through the retroperitoneum below the spleen, having pierced the diaphragm. The transverse mesocolon had a 3 cm rupture, and the peritoneum overlaying the left lumbar transverse process adjacent to the ureter had a breach.
There was a laceration in the left psoas muscle. The small and big bowels, liver, spleen, pancreas, kidneys, and ureter, as well as the rest of the intra-abdominal viscera, were all normal. The perforations in the stomach’s posterior wall were excised, and the stomach was closed with a linear stapler.
The abdomen was closed using the mass closure technique after drains were placed in the left subphrenic space and pelvis, and the peritoneal cavity was lavaged with copious volumes of normal saline. Interrupted nylon sutures were used to close the wound on the abdomen. A prophylactic chest drain in the left fifth intercostal space in the mid-axillary line was placed.
The patient’s recuperation from surgery was uneventful. There were no further issues when the chest drain was withdrawn. Analgesics, physiotherapy, and mobilization were used to treat the fracture of the lumbar transverse process. At her follow-up appointment, she was symptom-free.
Discussion
Rib fractures can result in several intra-abdominal and intrathoracic problems. It has also been documented to produce mediastinal emphysema and pneumopericardium, and the expected consequences of surgical emphysema and pneumothorax.
Lower rib fractures are linked to intra-abdominal solid ■■■■■ injury, particularly to the liver and spleen, during blunt injuries; however, the fractured segment is rarely the cause of intra-abdominal hollow viscus injury. A similar case with numerous rib fractures that resulted in a fragment of the cracked rib piercing through the diaphragm to the stomach was documented in the Japanese literature.
As in our instance, investigations might be deceiving (imaging](https://howtodiscuss.com/t/how-do-you-do-a-reverse-image-search/118685). Pneumothorax and pneumoperitoneum were not discovered on the initial chest x-ray. Due to a supposed intact and dilated stomach and the proximity of the rib discovered discovered to this splenic flexure, the CT image suggested a colonic rather than gastric perforation. A shattered rib piece had pierced the diaphragm and perforated the stomach in our case.
Abdominal Injuries
Sports-related trauma has been claimed to cause 10% of all stomach injuries. The most prevalent contact sports causing abdominal damage include football, rugby, soccer, and wrestling.
Noncontact sports like downhill skiing, water, skiing, and horseback riding include high-speed deceleration systems that can cause significant injuries.
Bergqvist et al. found that 7.1 percent of abdominal trauma in Swedish youngsters was caused by sports in a retrospective cohort analysis comprising 348 incidents over 30 years (Table). Ice hockey (8 cases), skiing (6 cases), soccer (5 cases), pole vaulting (1 case), and gymnastics (1 case) were among the sports involved.
| Intra-Abdominal Pathology | Abdominal Wall Contusions | Splenic Ruptures | Ruptured Jejunum | Pancreatic Injury | Renal Injuries |
|---|---|---|---|---|---|
| No. of patients | 1 | 1 | 4 | 1 | 1 |
The same study compared recreational Cycling to organized athletics and discovered that this pastime was responsible for 12% of stomach damage in children. Cycling resulted in liver injuries, a mesenteric rupture, muscular lacerations, a stomach rupture, and colon injuries.
In addition to the diseases listed in Table. According to Balham, bicycle injuries have a higher injury severity index than other sports. Puranik’s pediatric bicycle injury data found that 9 percent of the 211 children under the age of 15 experienced internal ■■■■■ injuries.
The handlebar imprint can sometimes be visible along the upper edge of the abdomen. Bicycles and other types of sports-related vehicular use can cause abdominal injuries similar to those observed in car accidents.
Summary
Gastric perforation is a fascinating and uncommon rib fracture complication. Because clinical examinations and investigations might be deceptive, a high index of suspicion for intra-abdominal injury should be maintained, especially in patients with lower rib fractures. The need for careful exploration of all intra-abdominal organs during laparotomy is highlighted in this case, and the clinician should not be misled by imaging findings.
Broken Ribs: Everything You Need to Know
The lungs and heart are protected by the ribs, which form a cage-like structure in the chest cavity. The ribs are joined together by several layers of muscle.
Broken ribs can vary in severity. A hairline fracture in one or more rib bones, while painful, is usually not a cause for concern and heals on its own.
However, it is not rare for people to have many broken ribs at the exact moment. The most common cause of significant rib fractures is blunt trauma, such as that sustained in an auto collision.
Learn about the signs and symptoms of a broken rib, as well as how doctors diagnose and treat the condition in this article. The recuperation process is also discussed.
Overview
A simple broken rib is when one of the rib bones in the chest has a hairline fracture. The broken bone’s edges can be forced out of place in more complicated fractures. A severe rib fracture can damage internal organs, nerves, and blood arteries damaged by a severe rib fracture.
A displaced broken rib’s sharp tip, for example, could puncture the lung. Pneumothorax is the name for this problem. Part of a rib can sometimes break off entirely and “float” or move around in the chest independently.
A dangerous condition known as flail chest can occur when three or more ribs are broken in two or more places. People who have a flail chest will have difficulty breathing and require medical assistance right away.
Risk Factors And Causes
A broken rib is most commonly caused by blunt trauma. The following are some of the causes of blunt trauma:
One or more broken ribs affect about 10% of persons who go to the hospital with traumatic chest injuries. A rib fracture can also be caused by severe coughing.
The upper or middle ribs are the most common sites for stress fractures. Broken ribs are more common in elderly adults and those with bone-related illnesses such as osteoporosis or osteopenia.
Symptoms
Below are the most common signs and symptoms of a broken rib:
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Bruising or swelling around the ribcage pain in the chest wall that gets worse with breathing, moving, or coughing.
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Trouble taking a deep breath.
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Shortness of breath.
Diagnosis
During a physical examination, a doctor will look for evidence of bleeding or bruises to diagnose a rib fracture. They may inquire about their pain levels and breathing difficulties.
A chest X-ray with rib detail is usually the following step. A simple hairline fracture will appear on the bone as a crack or jagged edge. On an X-ray, any segments of floating bone will be visible to the doctor.
A CT scan or ultrasound may be recommended if the doctor feels the break caused a lung harm, such as pneumothorax.
When Should You See A Doctor?
Anyone who beliefs has a broken rib should seek medical attention. If a person feels difficulty in breathing or is experiencing significant chest discomfort, they should dial 911 or the local emergency number right away.
If the Pain does not improve after therapy or if the person develops a fever or cough, should seek medical help.
Treatments
Fractures that are not complicated will typically heal on their own. Doctors may advise resting to help with the following:
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People should avoid actions that involve pulling, pushing, or lifting since they may aggravate the discomfort or cause more rib damage.
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Operation may require a person with more than one shattered rib, serious injury, or a flail chest. A surgeon would use plates and screws to join the broken ribs together during the procedure.
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Internal organs, nerves, and blood arteries would repair during surgery.
Recovering Time
Previously, doctors believed that the Pain and other symptoms of broken ribs lasted no longer than 6–8 weeks. Trusted Source, but new study reveals that many people suffer for much longer. Simple rib fractures can easily be treated at home. In more acute circumstances, the individual may require hospitalization.
Following are some advice and remedies which help you to recover faster:
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Clinicians frequently prescribe pain medicines during the healing process. Examples are examples of Acetaminophen or a nonsteroidal anti-inflammatory medicine like ibuprofen of them.
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Prescription pain drugs, such as opioids, may be required for people in severe pain. A doctor may also propose an injection called an intercostal nerve block.
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Ice can reduce swelling and pain while also preventing tissue damage. Before applying an ice pack or a bag of crushed Ice to an injured location, people should wrap it in a towel.
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Lung infections can occur due to rib fractures. To prevent this, a doctor may suggest that you practice deep breathing exercises.
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Taking a deep breath and holding it for as long as possible, then releasing the air and coughing vigorously are examples. If the exercise hurts, the user can support the rib area with their hands, a towel, or a pillow while doing it.
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Anyone who has broken a rib should refrain from participating in contact sports for at least 6 weeks, or as long as their doctor advises.
Summary
The severity of broken ribs varies. With rest, a minor fracture will heal on its own. It could take several weeks for the Pain to completely disappear. On the other hand, severe cases can result in major health problems. These will almost always necessitate hospitalization and may even necessitate surgery.
Rib Pain In The Right Upper Quadrant
The abdomen is divided into four regions, which are referred to as quadrants by medical practitioners. This classification aids in the identification of symptoms.
The pancreas, right kidney, gallbladder, liver, and intestines are all located in the right upper quadrant. A health problem affecting one of these organs or the surrounding tissues might cause Pain under the ribs in this location.
The nine reasons for discomfort in the RUQ, their remedies, and when to visit a doctor are described below:
1. Gastrointestinal Problems
Gastrointestinal problems, such as indigestion or gastroesophageal reflux disease, can cause RUQ pain (GERD).
GERD symptoms can include:
GERD can frequently be managed by following a healthy lifestyle, avoiding trigger foods, and taking antacid drugs.
2. Infection Of The Kidneys
An infection in the right kidney can cause pain in the RUQ. Other signs and symptoms of a kidney infection are:
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Groin and back pain
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Fever and chills
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Frequent need to urinate
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Discomfort when urinating
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Blood in the urine
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Dark or murky urine that smells awful
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Nausea
Bacteria or a virus could cause this illness, and it can spread from the bladder. Anyone who feels they have a kidney infection should seek medical attention as soon as possible. They may be given antibiotic medication.
If the infection is severe, the patient may need to be admitted to the hospital for intravenous fluids and maybe more therapy.
3. Kidneys Stones
The RUQ might be painful if a kidney stone occurs in the right kidney. Kidney stones can be a reason for the following symptoms:
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Blood in the urine can be red, pink, or brown color.
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Fever and chills
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Urination that is unpleasant.
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Frequent urination
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Inability to urinate
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Low urine levels
If a person suspects that discomfort is caused by kidney stones, or if they have other symptoms, they should contact a doctor as soon as possible.
The stone may be removed or broken into fragments that can be quickly passed through the body as part of the treatment.
4. Gallstones
The gallbladder is located beneath the liver in the RUQ. Gallstones are tiny deposits of cholesterol or bilirubin; a chemical produced when red blood cells degrade.
Being overweight is the most common cause of gallstones, mainly if the weight is concentrated around the waist.
Gallstones can result in:
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Fever and chills
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A strong pain in the RUQ that lasts for hours.
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Stools with a light color
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Brown urine
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The skin and eyes turn yellowish.
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Vomiting
If a person has any of these symptoms, they should see a doctor as soon as possible. If left untreated, gallstones can clog the bile ducts and create difficulties. Gallstones can treat removing the gallbladder, a non-essential ■■■■■.
5. Liver Abscess
A liver abscess is a collection of pus in the liver doctors refer to as a hepatic abscess or pyogenic liver abscess. Infection with parasites, bacteria, or fungi can cause pus.
In addition to discomfort or Tenderness in the RUQ, a liver abscess can cause:
A technique to drain the pus is usually used as part of the treatment. Antibiotics can often assist in the fight against bacterial infections.
6. Other Problems With The Liver
Other liver diseases, such as cirrhosis, fatty liver, and liver cancer, also cause pain in the RUQ.
Observe the following signs and symptoms:
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A feeling of fullness under the ribs in the RUQ
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Unintended weight loss due to a decrease of appetite or feeling full shortly after eating
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A bloated abdomen
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Skin and eye yellowing
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Itching
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Blood vessels visible on the abdomen
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Abdominal and right shoulder discomfort
Anyone who sees these symptoms should seek medical attention.
7. Preeclampsia
Preeclampsia is a condition that affects 5–8% of pregnant women. It usually appears between 20 weeks of pregnancy and 6 weeks following delivery.
Preeclampsia is a condition that produces swelling in the face, hands, and feet as a result of a sudden increase in blood pressure.
Other signs and symptoms include:
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RUQ soreness that could expand to the shoulder and lower back
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headache
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changes in eyesight
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shortness of breath
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vomiting
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weight increase of over 3–5 pounds in 1 week
A doctor must monitor blood pressure with regular prenatal checks. Even if no other symptoms are present, high blood pressure can indicate preeclampsia.
If a woman experiences any of the symptoms of preeclampsia, she should seek medical help right away because the disease can become dangerous if left untreated. Medications are generally prescribed as part of the treatment.
8. Pancreatitis
Pancreatitis is a disorder that causes pain under the ribs in the center of the abdomen, often known as the RUQ (left upper quadrant) (LUQ).
Pancreatitis is an inflammation of the pancreas that can be caused by gallstones or excessive alcohol consumption.
Pancreatitis symptoms include:
If someone has pancreatitis symptoms, they should consult a doctor straight soon because the condition can be life-threatening.
Mild Pancreatitis can disappear in a matter of weeks. If Pancreatitis is severe, a person may need to be admitted to the hospital for medicine and intravenous fluids.
9. Other Underlying Problems
Lung diseases, such as pneumonia, can produce pain under the ribs on the right side of the chest.
Pain in the RUQ might also be caused by circumstances in the surrounding area. Some examples are:
When Should You See A Doctor?
People who have recurrent or mild RUQ pain should consult a doctor and explain any other symptoms they are experiencing.
If you have any of the following symptoms, you should consult a doctor as soon as possible:
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unexpected weight loss
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a tinge of yellowness in the skin or eyes
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swollen abdomen
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dark stools
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stools or ■■■ with blood
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strong right-sided discomfort
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coughing or vomiting blood
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coughing up a substance resembling coffee grounds
Also, if you have any symptoms of preeclampsia or a kidney infection, consult a doctor right once. If these disorders are not treated, they can become dangerous.
Summary
Pain beneath the ribs in the RUQ can be caused by a variety of disorders affecting the organs or surrounding tissues in that location of the abdomen. These issues could be related to the liver or right kidney or gastrointestinal. Anyone experiencing persistent or severe pain on the right side of the abdomen should seek medical help right away.
Frequently Asked Questions (FAQS)
People asked many questions about “Broken Ribs Swollen Stomach” few of them were discussed below:
1. Can broken ribs cause stomach troubles?
Internal ■■■■■ damage might result from rib fractures. Symptoms include stomach or backache. You will feel nauseous or quite ill if you have internal bleeding. There is a necessity for immediate surgery.
2. Is it possible for ribs to induce stomach pain?
They can produce significant discomfort beneath the right and left sides of your rib cage or in your back, and the Pain can sometimes travel to the front of your abdomen. A high temperature is one of the other symptoms you may experience.
3. Is it possible for a broken rib to puncture your colon?
It is possible that a fractured rib ruptured the patient’s bowel, causing an ileus and then acute stomach dilatation, resulting to necrosis. However, there was no indication of a puncture wound to the underlying tissues, and the rib fractures were observed on radiology render this implausible.
4. When your stomach growls under your ribs, what does that mean?
Gastritis is an inflammation of the stomach lining, which is also located near the left side of the rib cage. A searing sensation in your stomach and an uncomfortable feeling of fullness in your upper abdomen are some symptoms of gastritis. Bacterial infections can induce gastritis.
5. Can broken ribs cause swelling feet?
Peripheral edema, or swelling of the legs, can be caused by various factors. Even though the edema started after your rib injury, it could be unconnected. Cardiomyopathy, or heart muscle anomalies, can result in heart failure, which can cause edema.
Conclusion
Gastric perforation is a fascinating and uncommon rib fracture complication. High suspicion of intra-abdominal ■■■■■ injury should be maintained, especially in patients with lower rib fractures. Pain beneath the ribs can be caused by various disorders affecting the organs or surrounding tissues.
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