An analysis of injury patterns of abdominal trauma in patients attending surgical emergency department of rural hospital, Karnataka, India

Background: Globally, abdominal trauma is a major public health problem irrespective of socioeconomic levels. Severe blood loss and infection are the serious complication of any abdominal trauma. A detailed assessment for early identification and prompt management is required to reduce the mortality and morbidity in any abdominal trauma. Hence this study was designed to assess the incidence and patterns of abdominal injuries in trauma patients.Methods: It was assorted and identified the incidence and sub type of abdominal injuries and associated trauma, and identified variables related to morbidity and mortality.Results: A total of 150 abdominal trauma cases were analyzed; 103 patients with blunt abdominal trauma and 47 with penetrating. The most frequent type of abdominal trauma was blunt trauma; its most common cause was motor vehicle accident. Most abdominal trauma patients presented with other injuries, especially patients with blunt abdominal trauma. Mortality was higher among penetrating abdominal trauma patients.Conclusions: Type of abdominal trauma, associated injuries, and Revised Trauma Score are independent risk factors for mortality in abdominal trauma patients.

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Hazard Ratio of 90-Day Mortality in ICU Patients with Abdominal Injuries Compared with Head Injuries

Archives of Iranian Medicine ◽

10.34172/aim.2021.134 ◽

2021 ◽

Vol 24 (12) ◽

pp. 897-902

Author(s):

Farshid Rahimi-Bashar ◽

Sara Ashtari ◽

Ali Fathi Jouzdani ◽

Seyed Jalal Madani ◽

Keivan Gohari-Moghadam

Keyword(s):

Head Trauma ◽

Abdominal Trauma ◽

Head Injuries ◽

Public Health Problem ◽

Hazard Ratio ◽

Major Public Health Problem ◽

Trauma Patients ◽

Abdominal Injuries ◽

Icu Patients ◽

Surgical Icu

Background: Despite advances in the treatment of abdominal injuries in patients with trauma, it remains a major public health problem worldwide. Evaluation of hazard ratio (HR) of 90-day mortality in intensive care unit (ICU) patients with abdominal injuries compare with head injuries in trauma patients and non-trauma surgical ICU patients. Methods: This single-center, prospective cohort study was conducted on 400 patients admitted to the ICU between 2018 and 2019 due to trauma or surgery in Hamadan, Iran. The main outcome was mortality at 90-day after ICU admission. Cox proportional hazards models were used to determine the HR and 95% confidence interval (CI) for 90-day mortality. Results: The 90-day mortality was 21.9% in abdominal injuries patients. According to multivariate Cox regression, the expected hazard mortality was 2.758 times higher in patients with abdominal injuries compared to non-trauma patients (HR: 2.758, 95% CI: 1.077–7.063, P=0.034). About more than 50% of all deaths in the abdominal and head trauma groups occurred within 20 days after admission. Mean time to death was 27.85±20.1, 30.27±18.22 and 31.43±26.24 days for abdominal-trauma, surgical-ICU, and head-trauma groups, respectively. Conclusion: Difficulty in accurate diagnosis due to the complex physiological variability of abdominal trauma, less obvious clinical symptoms in blunt abdominal injuries, multi-organ dysfunction in abdominal injuries, failure to provide timely acute care, as well as different treatment methods all account for the high 90-day mortality rate in abdominal-trauma patients. Therefore, these patients need a multidisciplinary team to care for them both in the ICU and afterwards in the general ward.

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Traumatic gastric rupture following blunt abdominal trauma: a case report about an atypical modality of presentation

Emergency Care Journal ◽

10.4081/ecj.2017.6609 ◽

2017 ◽

Vol 13 (1) ◽

Author(s):

Dario Giambelluca ◽

Dario Picone ◽

Natalino Carmelo Pennisi ◽

Bruno Luciani ◽

Giuseppe Lo Re ◽

...

Keyword(s):

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Rare Presentation ◽

Operative Morbidity ◽

Mortality And Morbidity ◽

Vehicle Accident ◽

Gastric Rupture ◽

History Of

Gastric rupture following blunt abdominal trauma is a rare presentation with a reported incidence of 0.02-1.7% in current literature. Traumatic gastric rupture is usually associated with other visceral injuries, such as splenic lesions and fractures. Prompt diagnosis and early intervention reduce mortality and morbidity. History of a recent meal has been implicated in traumatic gastric rupture. 2 We report a case of blunt abdominal trauma with an isolated gastric rupture after a motor vehicle accident, managed successfully without any post-operative morbidity and mortality.

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An experience with blunt abdominal trauma: evaluation, management and outcome

Clinics and Practice ◽

10.4081/cp.2014.599 ◽

2014 ◽

Vol 4 (2) ◽

Cited By ~ 24

Author(s):

Nikhil Mehta ◽

Sudarshan Babu ◽

Kumar Venugopal

Keyword(s):

Early Diagnosis ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

World Health ◽

Common Mechanism ◽

World Population ◽

Diagnosis And Management ◽

Time Of Presentation

Blunt abdominal trauma (BAT) is a frequent emergency and is associated with significant morbidity and mortality in spite of improved recognition, diagnosis and management. Trauma is the second largest cause of disease accounting for 16% of global burden. The World Health Organization estimates that, by 2020, trauma will be the first or second leading cause of <em>years of productive life</em> <em>lost</em> for the entire world population. This study endeavors to evaluate 71 cases of BAT with stress on early diagnosis and management, increase use of non operative management, and time of presentation of patients. A retrospective analysis of 71 patients of BAT who were admitted in Kempegowda Institute of Medical Sciences hospital (KIMS, Bangalore, India) within a span of 18 months was done. Demographic data, mechanism of trauma, management and outcomes were studied. Most of the patients in our study were in the age group of 21-30 years with an M:F ratio of 3.7:1. Motor vehicle accident (53%) was the most common mechanism of injury. Spleen (53%) was the commonest organ injured and the most common surgery performed was splenectomy (30%). Most common extra abdominal injury was rib fracture in 20%. Mortality rate was 4%. Wound sepsis (13%) was the commonest complication. Initial resuscitation measures, thorough clinical examination and correct diagnosis forms the most vital part of management. 70% of splenic, liver and renal injuries can be managed conservatively where as hollow organs need laparotomy in most of the cases. The time of presentation of patients has a lot to do with outcome. Early diagnosis and prompt treatment can save many lives.

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Challenges in management of blunt abdominal trauma: a prospective study

International Surgery Journal ◽

10.18203/2349-2902.isj20184078 ◽

2018 ◽

Vol 5 (10) ◽

pp. 3298

Author(s):

Rajkumar P. N. ◽

Kushal Kumar T. R. ◽

Deepak G.

Keyword(s):

Prospective Study ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Imaging Modality ◽

Tertiary Care ◽

Organ Injury ◽

Solid Organ ◽

Vehicle Accident

Background: Trauma meets the pandemic criteria, with a daily worldwide mortality as high as 16000. Abdominal trauma remains a leading cause of mortality in all age groups. Blunt abdominal trauma (BAT) mainly results from motor vehicle accident, fall from height and assaults. The commonest organ injured is the spleen, followed by the liver and small bowel. Lately, the management of BAT has changed from operative to non-operative management. This study was done to analyse the incidence, patterns, current management practiced, and challenges encountered in BAT treated operatively.Methods: This Prospective study was conducted in tertiary care centre in Bangalore during August 2015 to December 2017. 475 patients with blunt abdominal injuries who reported to emergency department were selected for the study based on following inclusion and exclusion criteria.Results: A total of 475 cases of BAT were assessed with a mean age of males and females was 32.6 and 28.3year respectively. Most patients (65%) were between 21 to 30 years of life. Most common mode of injury was motor vehicle accident (57.68%), 60% patients presented to hospital within the initial 4 hours. Abdominal CT had highest accuracy. Most common solid organ injury being spleen (26.5%). 80.84% patients were selected for SNOM and 15.62% had Failed SNOM. 28.48% patients had complications with most common complication wound infection followed by aspiration pneumonia and 7 patients had mortality.Conclusions: Initial resuscitation with thorough clinical examination with correct usage of imaging modalities with timely and proper decision making is the key of management of patients with BAT and there is a need to identify newer imaging modality/procedure which helps to determine better management scheme in all blunt trauma patients.

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Profile of Abdominal Trauma Patient Underwent Surgery in Emergency Operating Room of Sanglah General Hospital from January until December 2015

JBN (Jurnal Bedah Nasional) ◽

10.24843/jbn.2018.v02.i01.p01 ◽

2018 ◽

Vol 2 (1) ◽

pp. 1

Author(s):

Reza Halim ◽

Made Agus Dwianthara Sueta

Keyword(s):

General Hospital ◽

Operating Room ◽

Abdominal Trauma ◽

Medical Records ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Trauma Patients ◽

Vehicle Accident ◽

Liver Repair ◽

Emergency Operating

Objective: to investigate the characteristics of patients, presentation of the abdominal organ that involved, and clinical data associated with this event. Methods: this is a descriptive study with retrospective design. Total samples were all patients with abdominal trauma who underwent surgery on the emergency operating theatre of Sanglah General Hospital between January and December 2015. Baseline data of patients were obtained from the medical records. Results: within the study period, a total of 104 patients with abdominal trauma who underwent surgery in the emergency operating room of Sanglah General Hospital were identified. Man comprised 87.5% of the patients and mostly were 17-45 years old (75%). The motor vehicle accident occurred majority on the weekend (65%). Liver and spleen were the most affected organ (55%). Splenectomy (35%) and liver repair surgery (33%) were the most often performed procedures. Conclusion: Abdominal trauma caused by motor vehicle accident occurred mostly on the weekend. Two most affected organs in abdominal trauma were liver and spleen. Splenectomy and liver repair surgery were the procedures performed for these trauma patients.

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Emergency Ultrasound Predicting the Need for Therapeutic Laparotomy among Blunt Abdominal Trauma Patients in a Sub-Saharan African Hospital

Emergency Medicine International ◽

10.1155/2014/793437 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

P. C. M. Musiitwa ◽

M. Galukande ◽

S. Bugeza ◽

H. Wanzira ◽

R. Wangoda

Keyword(s):

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Standard Of Care ◽

Routine Practice ◽

Trauma Patients ◽

Diagnostic Challenge ◽

Mortality And Morbidity ◽

Portable Ultrasound ◽

Sub Saharan ◽

Overall Mortality

Background. The trauma burden globally accounts for high levels of mortality and morbidity. Blunt abdominal trauma (BAT) contributes significantly to this burden. Patient’s evaluation for BAT remains a diagnostic challenge for emergency physicians. SSORTT gives a score that can predict the need for laparotomy. The objective of this study was to assess the accuracy of SSORTT score in predicting the need for a therapeutic laparotomy after BAT.Method. A prospective observational study. Eligible patients were evaluated for shock and the presence of haemoperitoneum using a portable ultrasound machine. Further evaluation of patients following the standard of care (SOC) protocol was done. The accuracy of SSORTT score in predicting therapeutic laparotomy was compared to SOC.Results. In total, 195 patients were evaluated; M : F ratio was 6 : 1. The commonest injuries were to the head 80 (42%) and the abdomen 54 (28%). A SSORTT score of >2 appropriately identified patients that needed a therapeutic laparotomy (with sensitivity 90%, specificity 90%, PPV 53%, and NPV 98%). The overall mortality rate was 17%.Conclusion. Patients with a SSORTT score of 2 and above had a high likelihood of requiring a therapeutic laparotomy. SSORTT scoring should be adopted for routine practice in low technology settings.

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Blunt abdominal trauma in Sanglah Hospital Bali, Indonesia: a study of 65 cases

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20193951 ◽

2019 ◽

Vol 7 (9) ◽

pp. 3575

Author(s):

Putu Gosen Partama ◽

Made Agus Dwianthara Sueta

Keyword(s):

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Hypovolemic Shock ◽

Organ Damage ◽

Retroperitoneal Haematoma ◽

Common Cause ◽

Vehicle Accident ◽

Common Clinical Presentation

Abdominal trauma is a challenge for every surgeon, whether related to diagnosis or treatment. In developing countries, the number of traumatic events associated with death makes it necessary for a study to be carried out to see the patterns and damage caused by abdominal trauma and the organs involved. Material and Method is all patients with blunt trauma of the abdomen who came to emergency unit Sanglah Hospital Bali, from January 2017 up to May 2018 that undergo laparotomy exploration were enrolled, the data were collected retrospectively using patient medical records. Results is 65 patients with blunt abdominal trauma came to the emergency department and undergoes laparotomy exploration, range of age was 4-74 year old and 75.3% of them were men. The most common injured organs were spleen and liver, both are 26 and 15 cases (40 and 23%). Another intraoperative finding are Ileum Perforation (10 cases) Left Zone II Retroperitoneal Haematoma (7 cases), and Mesenterium Rupture (5 cases). Splenectomy was the most performed procedure (26 cases). The most common cause of blunt abdominal trauma was motor vehicle accident. Hypovolemic shock was the most common clinical presentation (48 patient). The Conclusions are according to this study, men consisted 75.3% cases of blunt abdominal trauma and the range age of patients was 4-74 year old. The most common cause was motor vehicle accident. Among patients with intra-abdominal organ damage, spleen and liver were most commonly involved. About 84.6% of all patients with blunt abdominal trauma were discharged without complication and morbidity.

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A prospective and retrospective study on conservative management of hepatic and splenic injury following blunt abdominal trauma

International Surgery Journal ◽

10.18203/2349-2902.isj20202061 ◽

2020 ◽

Vol 7 (6) ◽

pp. 1930

Author(s):

Induchoodan Ponnamma Pillai Sukumaran Nair ◽

Rajesh P. S.

Keyword(s):

Abdominal Trauma ◽

Conservative Management ◽

Blunt Abdominal Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Road Traffic ◽

Operative Management ◽

Splenic Trauma ◽

Solid Organ ◽

Non Operative Management

Background: worldwide road traffic accidents accounts as the leading cause of death of young people. For a very long time most of the intra-abdominal injuries following blunt abdominal trauma were managed operatively. Conservative management is becoming more acceptable and effective management option for blunt abdominal trauma during the last few decades.Methods: This study was conducted in Government Medical College, Kottayam during September 2007 to December 2008. All conservatively managed blunt abdominal trauma patients during the study period were included in the study.Results: Out of 22 patients, 4 patients failed conservative management. Success rate was 81%. Most commonly injured solid organ in the study group was liver (77%). Maximum cases were of age group 10 to 20 (31.81%) years. 81% of patients were males. Motor vehicle accident was the most common cause of trauma (77%). Mean stay in intensive care unit was 4.2 days and mean hospital stay was 15.7 days. Mean systolic blood pressure was 110 mmHg ranging from 70 to 130 mmHg. 50% of patients had moderate hemoperitoneum and non-had massive hemoperitoneum.Conclusions: Non operative management is safe and effective approach in blunt spleen and liver injuries. Non operative management should be treatment of choice for all hemodynamically stable patients with blunt liver and splenic trauma.

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A retrospective study of blunt trauma abdomen in a tertiary center in central India: evaluation, management and outcome

International Surgery Journal ◽

10.18203/2349-2902.isj20203256 ◽

2020 ◽

Vol 7 (8) ◽

pp. 2696

Author(s):

Sanjay Sisodiya ◽

Prateek Malpani

Keyword(s):

Retrospective Study ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Early Recognition ◽

Imaging Techniques ◽

Abdominal Injury ◽

High Morbidity ◽

Tertiary Center

Background: Blunt abdominal trauma is fairly common emergency and it is one of the important components of polytrauma. It requires high degree of suspicion, investigation and management. Inspite of improved imaging techniques leading to early recognition it is still associated with high morbidity and mortality. Trauma is the leading cause of blunt abdominal injury. This aim of the study was to find etiology, early diagnosis and management of patients with blunt abdominal trauma.Methods: This a retrospective study conducted in Gandhi medical college, Bhopal in which 90 cases of blunt abdominal trauma presented to emergency and outpatient department were included in the study duration of January 2019 to December 2019.Results: Motor vehicle accident was the most common mode of injury. Liver being the most common visceral organ injured while the most common surgery performed was the repair or resection and anastomosis of hollow viscous perforation. Rib fracture was the most common extra abdominal injury seen in 17.7% cases. Mortality rate was 5.5%. Most of the liver, spleen and renal injuries can be managed non-operatively whereas hollow viscous injury needs laparotomy.Conclusions: The result of present study is similar to other studies. Rapid diagnosis, early and timely referral, adequate and trained staff, close and careful monitoring, early wise and skilled decision to go for operative or non-operative management can help save many lives.

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