scholarly journals Epidemiology and injury pattern in blunt trauma abdomen in pediatric population: a two-year experience in a tertiary care institute of Kashmir, India

2018 ◽  
Vol 5 (11) ◽  
pp. 3713
Author(s):  
Arshid Iqbal Qadri ◽  
Younis Ahmad ◽  
Gowhar Aziz Bhat ◽  
Aamir A. Khan ◽  
Khalid Bashir

Background: Blunt abdominal trauma is a frequent cause for presentation of children to the Emergency Department. Children are prone to sustain injuries to intra-abdominal organs after blunt abdominal trauma because of their peculiar body habitus and relatively immature musculoskeletal system. Objectives of this study is to assess the various epidemiological parameters that influences the causation of trauma as well as injury pattern in blunt trauma abdomen in pediatric population.Methods: The present observational hospital based prospective study was carried out in 96 blunt abdominal trauma patients of both sexes aged up to 12 years, over a period of 2 years. The parameters such as age group, sex, mode of trauma, type of injury, and the overall mortality as well as mortality were assessed.Results: The most common mode of injury was road traffic accidents (54.2%) followed by fall from height (41.70%). Splenic injury was the most common in 58.30%, followed by hepatic injuries 34.40% and renal injuries 12.50 %. The accuracy of ultrasonography (USG) was 83.33% while accuracy of computed tomography (CECT) as a diagnostic test was 93.33%. When comparing USG findings with operative findings sensitivity of USG was 88% with positive predictive value (PPV) of 91.66% while as specificity was 60% with negative predictive value (NPV) of 50%. Sensitivity of CT scan was 96.00% with PPV of 96.00% and specificity of CECT scan was 80.00% with NPV of 80.00%.Conclusions: The majority of pediatric injuries are preventable by knowing the epidemiology and pattern of pediatric trauma.

2017 ◽  
Vol 68 (3) ◽  
pp. 276-285 ◽  
Author(s):  
Francesco Cinquantini ◽  
Gregorio Tugnoli ◽  
Alice Piccinini ◽  
Carlo Coniglio ◽  
Sergio Mannone ◽  
...  

Background and Aims Laparotomy can detect bowel and mesenteric injuries in 1.2%–5% of patients following blunt abdominal trauma. Delayed diagnosis in such cases is strongly related to increased risk of ongoing sepsis, with subsequent higher morbidity and mortality. Computed tomography (CT) scanning is the gold standard in the evaluation of blunt abdominal trauma, being accurate in the diagnosis of bowel and mesenteric injuries in case of hemodynamically stable trauma patients. Aims of the present study are to 1) review the correlation between CT signs and intraoperative findings in case of bowel and mesenteric injuries following blunt abdominal trauma, analysing the correlation between radiological features and intraoperative findings from our experience on 25 trauma patients with small bowel and mesenteric injuries (SBMI); 2) identify the diagnostic specificity of those signs found at CT with practical considerations on the following clinical management; and 3) distinguish the bowel and mesenteric injuries requiring immediate surgical intervention from those amenable to initial nonoperative management. Materials and Methods Between January 1, 2008, and May 31, 2010, 163 patients required laparotomy following blunt abdominal trauma. Among them, 25 patients presented bowel or mesenteric injuries. Data were analysed retrospectively, correlating operative surgical reports with the preoperative CT findings. Results We are presenting a pictorial review of significant and frequent findings of bowel and mesenteric lesions at CT scan, confirmed intraoperatively at laparotomy. Moreover, the predictive value of CT scan for SBMI is assessed. Conclusions Multidetector CT scan is the gold standard in the assessment of intra-abdominal blunt abdominal trauma for not only parenchymal organs injuries but also detecting SBMI; in the presence of specific signs it provides an accurate assessment of hollow viscus injuries, helping the trauma surgeons to choose the correct initial clinical management.


2020 ◽  
pp. 1-3
Author(s):  
Kaushik Mandal ◽  
Anirban Bhunia

Blunt abdominal trauma (BAT) is one of the most common injuries most often results from a motor vehicle collision and such incidents, combined with pedestrian versus automobile collisions. Aims: To evaluate the demographic and clinical profile, diagnosis and management of blunt abdominal trauma Methods: Our study was conducted over a period of 1 year (April 2019 to march 2020). A total no of 107 patients fulfilling inclusion criteria are allotted in the study and those with severe head injuries, vascular injuries and with major comorbidities are excluded from the study. Results: Males are predominantly affected. It is mostly seen in the age group of 21-40 yrs which form the young and reproductive group. Road traffic accidents form the most common mode of injury. FAST is a very important investigation. The most commonly injured organ in present study is liver which is managed by hepatorraphy and absorbable gelatin sponge packing. The present study showed a mortality rate of 6.5%.


2015 ◽  
Vol 53 (200) ◽  
pp. 227-230
Author(s):  
Om Bahadur Karki

Introduction: Blunt injury trauma is regularly encountered in the emergency department. Diagnostic tools that help in optimum management of blunt abdominal trauma include; Focussed Assessment Sonography for Trauma scan, Diagnostic peritoneal lavage and Computed Tomography scan. The aim of this study is to determine the validity of CT scan as an accurate diagnostic tool and its role in management of patients with blunt abdominal trauma. Methods: A prospective analysis of 80 patients of blunt abdomen trauma who were admitted in Manipal Teaching Hospital, Pokhara, Nepal within a span of 15 months was done. Demographic data, mechanism of trauma, management and outcomes were studied. Organ injuries were graded using the Organ Injury Scale guidelines. Results: Most of the patients in our study were in the age group of 21-40 years with an M: F ratio of 2.3:1. Road traffic accident (47.5%) was the most common mechanism of injury. Spleen (27.5%) was the commonest organ injured. CT scan was superior to FAST scan and had sensitivity of 97.3% specificity 75% positive predictive value 98.6%. FAST scan had sensitivity of 78.9%, specificity 50%, positive predictive value 96% with p- value of 0.0034. 81% of patients were conservatively managed. Conclusions: In conjunction with close clinical monitoring, CT scan is reliable in the evaluation and management of blunt abdominal trauma patients. Our study also shows CT as a superior diagnostic modality compared to FAST scan. Keywords: blunt abdominal trauma; CT scan; FAST scan; road traffic accident.


Author(s):  
Deepak Singh Panwar ◽  
Ashok Kumar

Background: In view of increasing number of vehicles and consequently road traffic accidents, this dissertation has been chosen to study the cases of blunt abdominal trauma with reference to the patients presenting at P.B.M. hospital, attached to S.P. Medical College, Bikaner. Methods: Prospective hospital-based study was conducted on all the patients of blunt abdominal injury admitted in the department of surgery, S.P. Medical College and P.B.M. Hospital, Bikaner. Results: Majority of the patients presented with abdominal pain (86%) and abdominal tenderness (81%). Conclusion: We concluded that young Males are predominantly affected.  Road traffic accident forms the most common mode of injury.  Though conservative management is successful in carefully selected patients, operative management remains the main stay of treatment. Keywords: Blunt trauma, Age, Sex


2015 ◽  
Vol 3 ◽  
pp. 1-4 ◽  
Author(s):  
Anjan Kumar Dhua ◽  
Manoj Joshi

Abstract Isolated duodenal perforation (IDP) in pediatric trauma is rarely reported. Since most of the children with blunt trauma are managed expectantly, timely diagnosis is imperative to avoid morbidity and mortality. We report a case of IDP and emphasize on certain specific clinical features indicating possibility of duodenal injury. We also stress upon the role of early contrast-enhanced computerized tomography (CECT) in such cases.


2020 ◽  
Vol 19 (2) ◽  
pp. 140-146
Author(s):  
Amir Hinbis Masawod ◽  
◽  
Hazim Jabbar Kashtal ◽  
Ahmed Modher Khalaf

Background: Blunt abdominal trauma is a common problem in our country.Some of the cases had been explored on no bases which were negative by FAST(focused assessment with sonography of trauma)FAST is a tool to detect intra-abdominal collection. Objective: To appreciate the value of (FAST) in blunt abdominal trauma. Patients and Methods: This study performed by a collection of 100 cases of blunt abdominal trauma admitted to the emergency department at Baquba Teaching Hospital from the period 1st January, 2013 to 31st December 2013 fast performed on all cases to detect any intra-abdominal collection, then correlation with this result and laparotomy or conservative results. Results: Out of 100 patients, Twenty seven cases had intra-abdominal collection and seventy three cases had no intra-abdominal collection by fast, 27 cases were positive and one case false positive and 73 cases were negative and 2 false-negative results and 71 true negative. The sensitivity was 92.8 % and specificity 98.6%. The positive predictive value was 96.2 % and negative predictive value 97.2 % and the accuracy 97 %. Conclusion: Focused assessment sonography of trauma can detect intra-abdominal fluid accurately and rapidly, FAST potentially valuable tool for better assessment of trauma in the emergency department. Keywords: Focus assessment with sonography of trauma (FAST), blunt abdominal trauma, abdominal emergency


2017 ◽  
Vol 4 (3) ◽  
pp. 874 ◽  
Author(s):  
Parikshit Malhotra ◽  
Dhruv Sharma ◽  
Sanjiv Gupta ◽  
S. S. Minhas

Background: Blunt abdominal trauma (BAT), a common form of trauma, is one of the major causes of morbidity and mortality. The study was aimed at the study of spectrum of injuries to various intra-abdominal organs after blunt trauma and to ascertain cause/mode of BAT in a hospital of hilly locality of Shimla.Methods: A prospective study was designed to conduct in the department of Surgery, IGMC, Shimla, India during the period of one year from 1st June 2005 to 31st May 2006. A total of 30 patients who had sustained BAT with or without other associated injuries were selected. In all patient’s history was taken and detailed physical examination done while concomitant resuscitation was performed. Chest and abdominal radiographs were done in all patients.Results: BAT is a major cause of morbidity and mortality especially in young people in the 11-40 years’ age group. Males are affected more than females. Road traffic accidents are the predominant mode of injury however, a relatively high incidence of blunt abdominal trauma due to falls is observed in a hilly state like ours. Spleen and liver are the two commonly injured organs after blunt abdominal trauma.Conclusions: Proper early diagnosis with initial and adequate resuscitation is beneficial in having a good outcome in patients of BAT. 


2018 ◽  
Vol 1 (01) ◽  
pp. 11-14
Author(s):  
Subash Thapa ◽  
Madan Thapa

Introduction: This study was conducted to compare the role of USG and CT as noninvasive imaging techniques for assessing the patient with blunt abdominal trauma. Methods: A prospective longitudinal study was performed at the College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan in the department of Radiodiagnosis, from January 2011 through July 2013. Where 150 patients following abdominal injuries were recorded, including patient age group, sex and mode of injury. Patient underwent USG and CT evaluation. The role of USG and CT was compared in the diagnosis of blunt abdominal trauma. Results: In our study, 80% of patient with blunt abdominal injury were male with the M:F ratio of 4:1. Road traffic accident was the most common cause of blunt abdominal trauma (72%). There were 95 (92.22%) patients positive for free fluid by USG and CT where 15 had no organ injury. CT revealed organ injuries in 88 (85.43%) patients whereas USG detected 72 (69.90%) organ injuries. Spleen 42 (47.72%) was the most common organ to be injured followed by liver29 (32.95%), kidney 7 (7.9%) and pancreas 3 (3.4%). 16 (18.18%) patients out of 88 positive for organ injuries were not associated with free fluid. Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of USG for organ injury were 81.81%, 100%, 100%, 79.48% and 89.3% respectively. Conclusions: USG and CT are useful noninvasive tools in detecting free intraperitoneal fluid and organ injuries in patients with blunt abdominal trauma. CT is superior to detect organ injuries in patients with blunt abdominal trauma.


Author(s):  
Betül Tiryaki Baştuğ

Aims: In this study, we aimed to find the percentage of random pathologies and abdominopelvic region anomalies that are not related to trauma in pediatric patients. Background: An abdominal assessment of an injured child usually involves computed tomography imaging of the abdomen and pelvis (CTAP) to determine the presence and size of injuries. Imaging may accidentally reveal irrelevant findings. Objectives: Although the literature in adults has reviewed the frequency of discovering these random findings, few studies have been identified in the pediatric population. Methods: Data on 142( 38 female, 104 male) patients who underwent CTAP during their trauma evaluation between January 2019 and January 2020 dates were obtained from our level 3 pediatric trauma center trauma records. The records and CTAP images were examined retrospectively for extra traumatic pathologies and anomalies. Results: 67 patients (47%) had 81 incidental findings. There were 17 clinically significant random findings. No potential tumors were found in this population. Conclusion: Pediatric trauma CTAP reveals random findings. For further evaluation, incidental findings should be indicated in the discharge summaries.


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