scholarly journals Comprehensive study of blunt injury abdomen in medical college, Chennai, India

2018 ◽  
Vol 5 (12) ◽  
pp. 3909
Author(s):  
Vimala Gopalakrishnan ◽  
Sangamithra Anandaraja ◽  
Vinayak Rengan ◽  
Chetna Ravindra

Background: Abdomen is the third most common organ injured following extremities and head injury. CT scanning has increased the identification of injuries. The care of the trauma patient is demanding and requires dedication, diligence, and efficiency. To evaluate the type and frequency of injury of various intraabdominal organs in the blunt trauma of the abdomen.Methods: After a primary survey of these patients, brief history and complete physical assessment all the basic investigations were done. Skiagrams were taken routinely. Ultrasonogram (F.A.S.T SCAN) was done for all cases and a CT scan was done for selected cases.Results: Road traffic accident was the most common mode of injury accounting for 76% cases. 36% of the cases were in the third decade of their lives. Spleen was the most common injured organ accounting for 52% of the cases.Conclusions: Solid organs like spleen and liver were more commonly injured in blunt injury to abdomen than the other organs like mesentery, retroperitoneum, bladder etc.

1970 ◽  
Vol 5 (2) ◽  
pp. 24-28 ◽  
Author(s):  
M Ahmad ◽  
FN Rahman ◽  
MH Chowdhury ◽  
AKMS Islam ◽  
MA Hakim

This study was conducted at the Dhaka Medical College (DMC) morgue among 100 postmortem cases of Road Traffic Accident (RTA) victims over a period of one year. The objective of this study was to find out incidences of head injury among the RTA victims along with other injuries and also to overview the present situation of RTA in the country. Out of 100 cases, 64% were male and 36% female. The highest incidence of RTA (28%) was observed among the age group 31 to 40 years. The highest number of victims were pedestrians (68%). Considering recorded causality by type of collision, hit pedestrian was the most common (39%), followed by head on collision (20%). Regarding injury pattern in different parts of body, all the victims had multiple abrasion and bruise, 90% had laceration, 78% had injury to brain and 77% victims had injury to abdominal organs like liver and spleen. In the skull, Linear/fissured fracture was the commonest type of fracture (36%), followed by comminuted fracture (18%). Temporal bone was observed most prone to be fractured (23%), followed by parietal bone (17%). Most of the victims had subdural haemorrhage (43%), followed by sub arachnoid haemorrhage (36%). Key words: Road traffic accident, head injury, postmortem. DOI: 10.3329/jafmc.v5i2.4579 JAFMC Bangladesh Vol.5(2) (December) 2009, pp.24-28


2020 ◽  
Vol 22 (2) ◽  
pp. 110-117
Author(s):  
Md Mahmudul Islam ◽  
Khondkar AK Azad ◽  
Md Aminul Islam ◽  
Rivu Raj Chakraborty

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117


1975 ◽  
Vol 61 (1) ◽  
pp. 41-43
Author(s):  
W. M. Edmondstone

AbstractA case is demonstrated of a man presenting with neurological disturbance dating from a head injury sustained in a road traffic accident. Investigation revealed a cerebral aqueduct stenosis which was successfully treated at operation.


2019 ◽  
Vol 7 (1) ◽  
pp. 37-41
Author(s):  
Santosh Mishra ◽  
Kailash Chandra ◽  
Kumar Paudel

INTRODUCTION: Blunt abdominal trauma results in huge burden of morbidity and mortality among all age groups caused mainly by road traffic accident, fall from height and physical assault. This study was designed to evaluate the outcome of management of hemoperitoneum in blunt injury of abdomen. MATERIAL AND METHODS: This is a prospective observational study involving 100 cases of blunt abdominal injury during the period from 1st December, 2014 to 13th  March 2016 in UCMS-TH, Bhairahawa, Nepal. Documentation of the patients which included identification, history, clinical findings, diagnostic tests, operative findings, operative procedures, complications during hospital-stay was done. The decision regarding operative or non- operative management was made by specialist surgeon. RESULTS: The majority of the patients belonged to 21- 30 years age group. 72 cases were male while 28 were female. 93 patients were managed conservatively while 7 patients were operated. Most common mode of injury was road traffic accident (RTA) (74%) followed by fall form height (20%). Most common organ to be injured was spleen (65%) followed by liver (26%). 93 % patients underwent non-operative management while 7 % were operated. Mortality rate was 0% among the  non- operative and 14.29% in operative cases. CONCLUSION: Non operative management in patient with hemoperitoneum with regular monitoring of vitals and repeated clinical assessment can reduce the operative need , morbidity and length of hospital stay. Non-operative Management (NOM) for blunt abdominal injuries was found to be highly successful in 93% of the patients in this study.


2019 ◽  
Vol 08 (01) ◽  
pp. 039-046
Author(s):  
Mandaka Rajeev ◽  
Vattaparambil Shinihas ◽  
Pankaj Chauhan

Abstract Background In India, most factors related to road traffic accident (RTA) causation and outcome go improperly documented, and database regarding RTA-related traumatic brain injury (TBI) seems inadequate. Two-wheeler drivers form the largest segment of people affected by RTA. The socioeconomic and neurologic burden, imposed by TBI due to RTAs (largely preventable), is overwhelmingly significant, especially for a developing country like India. Materials and Methods Descriptive study involving patients, presenting to the casualty of Government Medical College, Kozhikode, Kerala, was performed, and various demographic features were analyzed. Usage of helmet and history of alcohol intake were also noted. Patients were evaluated according to their presenting Glasgow coma scale (GCS), investigated and either operated or managed conservatively, and their outcome was assessed with Glasgow outcome score (GOS) at 3 months. Results Bike drivers formed the single largest proportion of RTA victims (53.7%). Proportion of helmet users was 17.9%, whereas 21.9% were found with history of alcohol intake. There was a consistent trend toward a favorable outcome in patients with no alcohol intake (17.08% deaths compared with 34.07% patients with alcohol intake) and with helmet usage (14.55% compared with 22.18% in patients without helmet). However, the absolute contribution of these factors cannot be inferred. Conclusion Various factors related to RTA need evaluation for pooling and compilation of data at regional and national levels. Mandatory helmet laws and strict implementation and provision of subsidized helmets (standard, full coverage) will go a long way in reducing the burden on limited health resources.


2015 ◽  
Vol 4 (1) ◽  
pp. 13-17
Author(s):  
Mamunur Rashid Chowdhury ◽  
Md Anwarul Haque ◽  
Md Nasir Uddin ◽  
Md Saiful Islam ◽  
Sabrina Alam Mumu ◽  
...  

Day by day road traffic accident in Bangladesh is increasing. Mymensingh-Dhaka highway passes beside the Community Based Medical College Hospital, Bangladesh. We often have to manage a greater number of traumatic patients. In road traffic accident the incidence of fracture shaft of femur is the most common. That's why my study was done to evaluate the result of management of fracture shaft of the femur with antegrade interlocking intramedullary nailing under the department of Orthopedic Surgery in CBMCH,B in the period between January 2009 to July 2013. Total 88 patients were selected for interlocking nailing initially in the study. Out of them 8 patients did not report in subsequent follow up. So the result of the study was based on 80 patients (48 males; 32 females) with the range of 20- 68 years of age. The average age of the patient was 36 years. Motor vehicle accidents was the most common cause of fracture shaft femur (65%) and the second most common cause was fall from height (20%) specially fall from tree. Among the patients; right sided femur involvement was 67.5% (54) and left sided femur involvement was 32.5% (26). The majority fracture of the shaft of the femur was lower third (70%). The patients were mostly in the day-laborers' groups (35%), and, the next group was students. The mean union time was 18 weeks with the range of 15-30 weeks. After operation, complications were found such as; infection 3.75%(3), non-union 1.25% (1). Excellent functional outcome was found in 82.5% (66), good in 12.5% (10), fair in 5%(4). This functional outcome study was evaluated by Klemm & Borner 1 criteria. CBMJ 2015 January: Vol. 04 No. 01 P: 13-17


2019 ◽  
Vol 17 (01) ◽  
pp. 56-60
Author(s):  
Kapil Adhikari ◽  
Mukesh Kumar Gupta ◽  
Ashok Raj Pant ◽  
Raj Kumar Rauniyar

Background: Head injury is a common problem encountered in emergency department. Among various neurological diseases, cranio-cerebral trauma ranks high in order of frequency and gravity. In acute setting, computed tomography is modality of choice because of its high accuracy in detecting intracranial lesions. The study was done to analyze computed tomography findings in cerebral trauma in regards to sociodemographic characteristics and find out associations of Computed tomography findings with mechanism of injury and clinical manifestations.Methods: The study was carried in Department of Radiology, BPKIHS, over a period of one year from Aug. 2015 to Aug. 2016. 450 patients were included in our study and findings noted on structured pro forma. Analysis was done using SPSS version 20 applying simple descriptive statistical methods.Results: Among 450 patients, 220 patients (48.9%) had various cranio-cerebral injuries. Most were in age group of 20-29 years (49.5%) and most common mode was road traffic accident (44.6%).Most patients presented with altered sensorium (39.2%) and Glasgow Coma Scale score of ?13 (70.9%). Scalp lesion was the most common finding (24%) followed by bone fractures (19.8 %). Patients with road traffic accident (59.7%) and fall from height (46.7%) had more positive computed tomography findings than from physical assault (28.2%). Glasgow Coma Scale showed significant statistical association with computed tomography findings (p<0.001). Conclusions: Road traffic accident is the most common mode of head injury in young adults patients presenting in our hospital. Glasgow Coma Scale can be considered as an important clinical marker for predicting positive computed tomography findings. Also computed tomography is an important initial investigation to evaluate the various craniocerebral injury in trauma patients.Keywords: Computed tomography; Cranio-cerebral trauma; road traffic accident.


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