A wound that damages the abdominal wall and intraperitoneal and extraperitoneal organs and tissues. A careful examination (often including peritoneal lavage, ultrasonography, or computed tomographic scanning of the abdomen) is necessary to determine the precise nature of the injury and the proper course of treatment. Superficial injuries may require no more than ordinary local care; immediate laparotomy may be needed, however, when major bleeding or organ damage has occurred. Intravenous fluids, blood components, antibiotics, and tetanus prophylaxis are given when necessary. Major abdominal trauma may be overlooked in comatose or otherwise critically injured patients when there is no obvious abdominal injury.