Blunt abdominal trauma: a tertiary care experience

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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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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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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