In penetrating abdominal trauma, the organs most likely to be affected are:

• A. Heart and lungs
• B. Liver and small bowel
• C. Stomach and spleen
• D. Kidneys and bladder

Answer: (B)

Penetrating injuries to the abdomen most often involve structures inside the peritoneal cavity that are large, highly vascular, or highly mobile. The liver stands out because of its size and rich blood supply; a penetrating wound entering the abdomen can readily damage liver tissue and cause significant hemorrhage. The small bowel is also commonly injured because it fills much of the central abdomen and is quite mobile, so a penetrating object can easily transect or perforate loops as it traverses the cavity.

In contrast, kidneys and bladder are largely retroperitoneal or pelvic, so anterior abdominal penetrations are less likely to injure them unless the wound path is favorable. The stomach and spleen can be injured, but overall the combination of liver and small bowel reflects the organs most frequently affected by penetrating abdominal trauma.