Management of closed abdominal injuries, produced by blunt violence, is one of the most challenging problems that the surgeon has to meet. It is usually made difficult by presence of associated injuries of the head, chest, or extremities, and the obvious severity of these may largely or completely mask the early evidences of abdominal visceral injury. It should be emphasized that, in general, injuries of the head and chest take precedence over those of the abdomen, and it is in the "multipleinjury" cases that intra-abdominal injuries are most frequently overlooked or undertreated. Blows to the abdomen received in sports or industrial accidents are promptly recognized and the patient carefully observed. It is those sustained in a serious automobile crash, a fall from a height, or a blast that present the diagnostic problem.
Chester C. Guy, Blunt Injuries of the Abdomen, 13 Clev.-Marshall L. Rev. 448 (1964)