Role of multislice computed tomography in assessment of non-solid organ injury in patients with blunt abdominal trauma

Background: The present study of role of non-operative management in blunt abdominal trauma with solid organ injury was done to assess the feasibility and safety of non-operative management in hemodynamically stable patients and identify the causes, predictive factors to delineate the rate of non-operative management failure.Methods: A longitudinal observational study was carried out from September 2013 to November 2015. All cases of blunt trauma abdomen with ultrasonological e/o solid organ injury and were hemodynamically stable were included in study.Results: Total 138 cases presented with a history of blunt trauma abdomen of which 56 cases had ultrasonological evidence of solid organ injury. 8 cases were excluded as 6 of these were hemodynamically unstable at presentation while 1 had bowel perforation and another had severe head injury all requiring operative management. Maximum cases were of age group 21-30 years (41.66%) and 31-40 years (31.25%). 42 (87.5%) cases were male and 6 (12.5%) cases of 48 were females. 28 (66.67%) cases presented as Road Traffic Accident. 28 (66.67%) cases had abdominal pain as the commonest symptom while tenderness in 38 (79.17%) cases and tachycardia in 30 (75%) cases was the predominant sign. Most injuries were seen in spleen 23 (47.92%) cases f/b Liver with 14 (29.12%). Conservative management was successful in 40 (83.33%) cases and failed in 8 (16.67%) cases. Mortality of the study was 1 (2.08%) case.Conclusions: Non-operative strategy is a successful approach in patients who are hemodynamically stable and authors strongly recommend it.

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ROLE OF FOCUSED ABDOMINAL SONOGRAPHY FOR TRAUMA IN SOLID ORGAN INJURY IN PAEDIATRIC BLUNT ABDOMINAL TRAUMA

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2018/465 ◽

2018 ◽

Vol 7 (17) ◽

pp. 2074-2077

Author(s):

Rejum Ronya ◽

Rajib Ray Baruah ◽

Nirmal Bhattacharyya ◽

Jayanta Kumar Goswami ◽

Manoj Saha ◽

...

Keyword(s):

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Organ Injury ◽

Solid Organ ◽

Solid Organ Injury ◽

Abdominal Sonography

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Intra-abdominal Free Fluid without Solid Organ Injury in Blunt Abdominal Trauma: An Indication for Laparotomy

Journal of Trauma and Acute Care Surgery ◽

10.1097/00005373-200206000-00019 ◽

2002 ◽

Vol 52 (6) ◽

pp. 1134-1140 ◽

Cited By ~ 73

Author(s):

Alexander K. T. Ng ◽

Richard K. Simons ◽

William C. Torreggiani ◽

Stephen G. F. Ho ◽

Andrew W. Kirkpatrick ◽

...

Keyword(s):

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Organ Injury ◽

Free Fluid ◽

Solid Organ ◽

Solid Organ Injury

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0656: Evaluation of Ultrasonography for Solid Organ Injury in Blunt Abdominal Trauma. Experience at Mulago Hospital Makerere University Uganda

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2009.06.1057 ◽

2009 ◽

Vol 35 (8) ◽

pp. S90

Author(s):

Samuel Bugeza ◽

Else Kiguli Malwadde ◽

Zeridah Muyinda

Keyword(s):

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Organ Injury ◽

Mulago Hospital ◽

Solid Organ ◽

Solid Organ Injury ◽

Makerere University

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Blunt abdominal trauma: a tertiary care experience

International Surgery Journal ◽

10.18203/2349-2902.isj20180814 ◽

2018 ◽

Vol 5 (3) ◽

pp. 975

Author(s):

Vikram Trehan ◽

Sukumar S. Kumar

Keyword(s):

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Tertiary Care ◽

Hemodynamic Instability ◽

Morbidity And Mortality ◽

Organ Injury ◽

Solid Organ ◽

Care Hospital ◽

Management Options ◽

Solid Organ Injury

Background: Blunt abdominal trauma (BAT) is one of the common causes of admission in surgical ward in any hospital. It requires high level of suspicion, urgent evaluation and timely management to decrease morbidity and mortality. Aim of present study was to find out demographic details, causes of injury, management options and treatment outcomes of BAT.Methods: Retrospective study of cases of BAT was carried out at a tertiary care hospital of India spanning five years, between June 2012 to June 2017. Authors analyzed the demographic profile of the trauma victims, etiological factors of BAT, the abdominal organs involved, the treatment modalities adopted and the final outcome.Results: There were 231 cases of BAT. Most common age group was 11 to 30 years which accounted for 42.42% of the total. The study had 181 (78.35%) males and 50 (21.64%) females. Road traffic accident was the most common cause of BAT and it accounted for 67.97%. Liver (34.20%) was the most commonly involved organ followed by spleen (22.51%), bowel (15.58%), mesentery (8.23%), kidney (7.36%), pancreaticoduodenal injuries (3.46%) and diaphragm (3.46%). 56.71% underwent non-operative management (NOM), 3.90% underwent angio-embolization and 39.39% eventually required operative treatment. Mortality occurred in 31 patients (13.41%) because of septicemia, renal failure, shock, acute coronary event or respiratory complications.Conclusions: NOM for BAT was found to be successful in haemodynamically stable patient with solid organ injury. Along with sophisticated infrastructure like ultrasound or CT Scan, close supervision with repeated examination by a treating surgeon were the sheet anchors of NOM. Angio-embolization is a feasible modality of treatment in solid organ injury and can avoid surgery in an appropriate patient. Definitive indications for laparotomy were hemodynamic instability and perforation-peritonitis. Initial hemodynamic instability, haemorrhagic shock, and associated injuries influenced morbidity and mortality in BAT.

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