scholarly journals Outcome of gastrointestinal perforations due to blunt abdominal trauma

2018 ◽  
Vol 5 (8) ◽  
pp. 2836
Author(s):  
Anubhav Goel ◽  
Ankur Bansal ◽  
Bhupesh Gogia
Keyword(s):  
Blunt Trauma ◽  
Abdominal Trauma ◽  
Postoperative Period ◽  
Blunt Abdominal Trauma ◽  
Exploratory Laparotomy ◽  
Gastrointestinal Perforation ◽  
Common Site ◽  
Hollow Viscus ◽  
Abdominal Sonography ◽  
Isolated Injury

Background: The most common injury during blunt abdominal trauma (BAT) is of solid organs. Hollow viscus injuries are much more uncommon compared to the non-hollow ones. The most important problem associated with these conditions that they are frequently remain undetected or diagnosed too late despite advanced techniques such as focussed abdominal sonography for trauma (FAST), computer tomography, and magnetic resonance imaging. This study evaluates gastrointestinal perforation following blunt abdominal trauma, their anatomical distribution, diagnosis, management, and outcome.Methods: The study was a prospective observational study conducted after ethical clearance from hospital. The patients included were those presenting with features of peritonitis following blunt trauma, with isolated injury to abdomen and found to exhibit gastrointestinal perforation on exploratory laparotomy. Exclusion criteria were perforation was not detected at surgery, penetrating abdominal trauma. Data of each patient were collected into the Performa prepared for the study.Results: During the study period, 32 patients underwent surgery for perforation following blunt abdominal trauma. Jejunum was the most common site of perforation in the study subjects followed by ileum than stomach. Among the procedures performed, simple closure of perforation with peritoneal lavage was the most commonly performed procedure in 24 patients (75.0%). Resection anastomosis was done in 3 (9.3%) cases, while stoma was fashioned in 5 (15.6%) patients. 5 (15.6%) patients developed complications in the postoperative period with chest infection being the most common. One patient died in the postoperative period leading to mortality rate of 3.1%.Conclusions: To conclude, early diagnosis and treatment are of utmost importance. Most common site for perforation in blunt trauma is jejunum. Early surgery following adequate resuscitation in gastrointestinal perforation following blunt trauma abdomen is associated with a very a good outcome.

scholarly journals Isolated perforation of fourth part of Duodenum following Blunt Abdominal Trauma

2022 ◽  
Vol 19 (1) ◽  
pp. 106-108
Author(s):  
Prabir Maharjan ◽  
Shiv Vansh Bharti ◽  
Digbijay Bikram Khadka ◽  
Anup Karki ◽  
Arun Gnyawali
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Primary Repair ◽  
Exploratory Laparotomy ◽  
Hollow Viscus ◽  
Case Presentation ◽  
Fourth Part ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Duodenal Injuries

Introduction: Isolated duodenal injuries are rare in blunt abdominal trauma. These present a significant challenge for management because of the associated injuries and its difficult anatomical accessibility. Case presentation: A 20years male presented to the Emergency department following a bike accident sustaining injury over face, chest and abdomen, 6hours after the incident. His vitals were unstable so he was resuscitated and admitted in Intensive Care Unit. He had generalized abdominal tenderness without rigidity. Contrast enhanced computed tomography of abdomen and pelvis was suggestive of hollow viscus perforation. He underwent exploratory laparotomy and primary repair for isolated perforation at fourth part of duodenum. He was discharged on his ninth postoperative day. Conclusion: Rare injuries following blunt abdominal trauma should be considered and early intervention is necessary.

BLUNT ABDOMINAL TRAUMA WITH HAEMOPERITONEUM TREATED BY EXPLORATORY LAPAROTOMY VERSUS ONLY ABDOMINAL DRAINAGE: A PROSPECTIVE AND COMPARATIVE STUDY.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Dhawal Panchal ◽  
Firdaus Dekhaiya ◽  
Harin Tailor
Keyword(s):  
Hospital Stay ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Exploratory Laparotomy ◽  
Blunt Injury ◽  
Abdominal Drainage ◽  
Duration Of Hospital Stay ◽  
Considerable Morbidity ◽  
Injured Patients

In today’s mechanized world, Blunt Abdominal Trauma (BAT) is a common emergency which is associated with considerable morbidity and mortality. More than 75% of abdominal traumas are blunt in nature and liver and spleen are the commonest organs to be injured as a result of BAT. The aim is to analyse and compare two groups of patient of blunt abdominal trauma managed conservatively with drainage and one by exploratory laparotomy. 50 cases of blunt abdominal trauma were taken. The patient were studied  which includes age ,sex, mode of injury, initial vitals on presentation, Mortality in each group, duration of hospital stay, pre interventions and post interventions state and requirements, complications and follow up. It was observed 48% of patients were in between age group ranging from 10 to 30. Overall in terms of sex ratio, males dominated the no. of cases. RTA was most common mode of trauma. Liver and spleen was most common organ to be injured. Patients managed by laparotomy had higher mortality rate, duration of hospital stay was more, and complication were more. Early diagnosis and repeated clinical examination and use of appropriate investigation form the key in managing blunt injury abdomen patients. Keywords:  Blunt Abdominal Trauma, Haemoperitoneum , laparotomy , Abdominal Drainage.

scholarly journals Prospective study of management and outcome of blunt abdominal trauma (solid organs and hollow viscus injuries)

2017 ◽  
Vol 4 (10) ◽  
pp. 3262 ◽  
Author(s):  
Sandesh Kumar Srivastava ◽  
Anand Kumar Jaiswal ◽  
Dinesh Kumar
Keyword(s):  
Prospective Study ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Road Traffic ◽  
Age Groups ◽  
Initial Assessment ◽  
Age Group ◽  
Abdominal Injuries ◽  
Hollow Viscus ◽  
External Compression

Background: Blunt abdominal trauma is a leading cause of morbidity and mortality among all age groups. Many injuries may not manifest during the initial assessment and treatment period. Injury to intra-abdominal structures can be classified into 2 primary mechanism of injury-compression forces and deceleration forces. Compression or concussive force may result from direct blows or external compression against a fixed object. Deceleration forces causes stretching and linear shearing between relatively fixed and free objects.Methods: A prospective study of 48 patients admitted with blunt abdominal injuries in the department of surgery, B.R.D. Medical College Gorakhpur during a period of 1 year.Results: Majority of patients of blunt abdominal injuries in present study were in 11-20 year of age group followed by 31-40 year of age group followed by 41-50 year of age group. Female to male ratio was 7:1. In the present study 41% of patients were subjected to non-operative management.Conclusions: Males were pre-dominantly affected. Road traffic accident was the most common cause of injury. Though conservative management is successful in carefully selected patients, operative management remains the main stay of treatment.

Computed tomography has an important role in hollow viscus and mesenteric injuries after blunt abdominal trauma

Injury ◽  
2010 ◽  
Vol 41 (5) ◽  
pp. 475-478 ◽  
Author(s):  
Ker-Kan Tan ◽  
Jody Zhiyang Liu ◽  
Tsung-Shyen Go ◽  
Appasamy Vijayan ◽  
Ming-Terk Chiu
Keyword(s):  
Computed Tomography ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Hollow Viscus

Imaging gastrointestinal perforation in pediatric blunt abdominal trauma

1996 ◽  
Vol 26 (3) ◽  
pp. 188-194 ◽  
Author(s):  
D. H. Jamieson ◽  
P. S. Babyn ◽  
R. Pearl
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Gastrointestinal Perforation

The Utility of Sonography for the Triage of Blunt Abdominal Trauma Patients to Exploratory Laparotomy

2007 ◽  
Vol 188 (2) ◽  
pp. 415-421 ◽  
Author(s):  
Brett C. Lee ◽  
Eleanor L. Ormsby ◽  
John P. McGahan ◽  
Giselle M. Melendres ◽  
John R. Richards
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Exploratory Laparotomy ◽  
Trauma Patients

Morbid Obesity’s Silver Lining: An Armor for Hollow Viscus in Blunt Abdominal Trauma

2018 ◽  
Vol 43 (4) ◽  
pp. 1007-1013 ◽  
Author(s):  
Chih-Yuan Fu ◽  
Francesco Bajani ◽  
Caroline Butler ◽  
Stanley Welsh ◽  
Thomas Messer ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Hollow Viscus ◽  
Silver Lining

scholarly journals Isolated Cecal Rupture after Blunt Abdominal Trauma

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Alemayehu Ginbo Bedada ◽  
Elijah Wade Riddle ◽  
Alemayehu Bekele Eshetu ◽  
Georges Azzie
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
High Speed ◽  
Motor Vehicle ◽  
Right Hemicolectomy ◽  
Motor Vehicle Crash ◽  
Hiv Positive ◽  
Colon Anastomosis ◽  
Hollow Viscus ◽  
Superficial Wound

Cecal perforation following blunt abdominal trauma is an uncommon and challenging injury. We report a 19-year-old HIV-positive woman who presented with abdominal pain after a high-speed motor vehicle crash. Abdominal exam revealed a seatbelt sign with evidence of peritonitis; Focused Assessment with Sonography for Trauma showed free intraperitoneal fluid. After fluid resuscitation and antibiotics, the patient was taken for urgent laparotomy. Intraoperatively, we discovered hemoperitoneum and an isolated rupture of the cecum. A right hemicolectomy with end-to-end ileo-transverse colon anastomosis was performed. Her only significant postoperative complication was a superficial wound infection. We review the epidemiology of hollow viscus injury in blunt trauma and discuss important considerations in diagnosis and treatment. Keywords: Blunt abdominal trauma, Cecal rupture, HIV positive, Hollow viscus

scholarly journals Isolated free fluid on computed tomography for blunt abdominal trauma

2019 ◽  
Vol 101 (8) ◽  
pp. 552-557
Author(s):  
W Bekker ◽  
MTD Smith ◽  
VY Kong ◽  
JL Bruce ◽  
G Laing ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Splenic Injury ◽  
Operative Management ◽  
Bladder Injury ◽  
Free Fluid ◽  
Abdominal Ct ◽  
Hollow Viscus ◽  
Hollow Viscus Injury ◽  
Non Operative Management

Introduction The clinical significance of isolated free fluid on abdominal computed tomography (CT) in patients with blunt abdominal trauma is unclear. This audit reviews our unit’s experience with isolated free fluid and attempts to refine our clinical algorithms for the assessment of patients with blunt abdominal trauma. Materials and methods All patients who sustained blunt abdominal trauma between December 2012 and December 2017 who were subjected to multidetector CT of the abdomen as part of their initial investigation were included in this study. Results During the five-year period under review, a total of 1066 patients underwent abdominal CT following blunt poly trauma. A total of 84 (7.9%) patients died. There were 148 (14%) patients with CT finding of isolated free fluid. Of these, 128 (67%) were selected for non-operative management, which included a period of serial abdominal examinations. In this non-operative group, five patients failed their abdominal observations and underwent laparotomy. Findings in these five cases were negative (1), non-therapeutic (1), splenic injury (1), Pancreatic and splenic injury (1) and bladder injury (1). Thirteen patients (10%) died, none of whom had surgery. The causes of death were exsanguination from a major traumatic lower limb injury (1), multiple organ failure (1), traumatic brain injury (10) and spinal cord injury (1). The remaining 20 patients underwent laparotomy. The indications were failed non-operative management (5), abdominal distension (1) and suspicion of a missed hollow viscus injury (14). In this group there were 11 therapeutic and 6 non-therapeutic surgeries and three negative laparotomies. For the 15 patients selected for operative management, the findings were as follows: hollow viscus injury (3), mesenteric bleeds (2), splenic and pancreatic injury (1), liver and bladder injury (1), splenic and bladder injury (1), non-therapeutic (4), negative (3). The finding of isolated free fluid on CT is 98% sensitive and 96% specific for true isolated free fluid (chi square 331.598; P = 0.000). This finding predicts successful non-operative management with a positive predictive value of 93% and a negative predictive value of 96%. Discussion In patients with blunt abdominal trauma, the finding of isolated free fluid on abdominal CT alone is no longer an indication for laparotomy. Other clinical factors must be taken into account when deciding on the need for laparotomy, such as haemodynamic status, clinical abdominal findings and the ability to reliably assess the abdomen. In the absence of a clinical indication for urgent laparotomy, patients with isolated free fluid may be observed.

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