The stomach is the expandable, pouch-like portion of the upper gastrointestinal tract situated between the esophagus and duodenum. Food in the stomach stimulates the production of gastrin that in turn increases the production of gastric juice. Many digestive functions begin in the stomach. Because of the location of the stomach, below the diaphragm and partly under the liver, it may be subjected to blunt and penetrating injuries. The term injury is usually applied to damage by an external force which may not be visible from the outside. Residuals are the aftermath of an injury. Stomach injury residuals are the complications following trauma to the stomach.

The stomach may be injured by blunt trauma from motor vehicle accidents, falls from heights, or sporting events. Penetrating injuries may result from stab or gunshot wounds.

Signs and symptoms may vary with the nature, type and extent of injury (pain may be absent in severe injuries). Manifestations of blunt injury to the abdominal area include: severe pain radiating beyond the abdomen and into the shoulders; abdominal rigidity; bruises, abrasions and contusions; nausea and vomiting; possible bloody emesis; pallor or cyanosis; and tachycardia or dyspnea. Indications of penetrating stomach injuries include blood loss, pain and tenderness; and possible pallor, cyanosis, diaphoresis, tachycardia, dyspnea, and hypotension.

Diagnostic measures for this condition may include: abdominal x-rays; x-ray for free air in the abdomen; computed tomography (CT) scan; magnetic resonance imaging (MRI); ultrasonography; gastroscopy; laboratory examinations to measure blood loss; and stomach aspiration for blood.

Treatment will depend on the extent of the injury. Possible emergency treatment will be required for hemorrhage and shock. A nasogastric tube is usually placed in patients suspected of active bleeding. Penetrating wounds may require surgical repair or partial removal of the stomach. Blunt injury may require hospital monitoring and observation for 24 hours.

If gastric surgery and resection is required to control bleeding from perforation, the postoperative residuals may include symptoms of dumping syndrome, or postprandial hypoglycemia or bile reflux gastritis or both. Another possible residual outcome might be adhesions (see Diagnostic Code: 7301 Peritoneum, adhesions of).

• None.

• Rate as peritoneal adhesions.

• Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation.