ABDOMINAL INJURIES - Medicine for Mountaineering and Other Wilderness Activities - page 126

feels far more sore and stiff a day or two after a fall than immediately after the injury. If no
associatedinjuriesarepresent,thepersonusuallyrecoversafterafewdaysofrestandmild
to moderate analgesia every four to six hours.
Internal Bleeding Due to Ruptured Liver, Spleen, or Kidney
A blow to the abdomen may rupture the liver, spleen, kidney, or some combination of
them. Rupture is more likely if the blow strikes immediately over the organ. The liver lies
in the right upper quadrant, the spleen in the left upper quadrant. Both are tucked under the
rib cage but can be injured by blows to either the upper abdomen or lower part of the chest
( Fig. 10-1 ) . A blow from the back may damage the kidneys, which lie on either side of the
backbone( Fig.10-2 ).Theseorgansaresolidandmayshatterwhenhitdirectly.Bloodfrom
a severely injured liver or spleen flows unimpeded into the abdominal cavity. The hemor-
rhage often does not stop without operative intervention.