Abdominal counter-pressure bandage in traumatic haemoabdomen
5-year-old Belgian Shepherd hit by a car. AFAST shows fluid at several sites and abdominocentesis yields non-clotting blood. Despite crystalloid boluses, systolic pressure remains at 75 mmHg. TFAST and thoracic radiographs show no pneumothorax or diaphragmatic hernia.
You decide to place an abdominal counter-pressure bandage. Which statement is correct?
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A. It is applied from the pelvis to the xiphoid, breathing is monitored and it is removed gradually over several hours while monitoring blood pressure
Correct. The bandage raises intra-abdominal pressure, helps tamponade bleeding and redistributes blood towards the thorax. Removing it abruptly can cause sudden hypotension or rebleeding, so it is loosened in stages, from cranial, with monitoring.
B. The caudal thorax should be included in the bandage to increase compression
Including the thorax limits chest expansion and can cause hypoventilation, especially in a trauma patient with possible pulmonary contusion.
C. It allows fluid and blood-product resuscitation to be reduced, because it stops the bleeding on its own
It is a temporary adjunct. Resuscitation (crystalloids, whole blood or packed red cells and plasma if needed) and reassessment remain essential.
D. It is also appropriate if there is a diaphragmatic hernia, to push the viscera back into the abdomen
On the contrary: with a diaphragmatic hernia the bandage pushes more viscera into the thorax and worsens ventilation. Diaphragmatic hernia and severe thoracic trauma are contraindications.
lightbulb Key takeaway
An abdominal counter-pressure bandage is a bridge while you resuscitate or prepare for surgery. Rule out thoracic injuries and diaphragmatic hernia first, monitor respiratory rate, urine output and blood pressure, and remove it gradually.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.