Pediatric Blunt Abdominal Trauma- Demography in a Tertiary Care Set Up of a Developing Nation

2017 ◽  
Vol 11 (1) ◽  
pp. 11
Author(s):  
Soumyodhriti Ghosh ◽  
Ramendra Shukla ◽  
Vikram Singh Mujalde ◽  
Mushahid Ali ◽  
Sunil Mehra ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Tertiary Care ◽  
Developing Nation ◽  
Set Up

scholarly journals Challenges in management of blunt abdominal trauma: a prospective study

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. 

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
Keyword(s):  
Blunt Trauma ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Predictive Value ◽  
Road Traffic ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Pediatric Trauma ◽  
Injury Pattern ◽  
Trauma Patients

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.

scholarly journals Blunt abdominal trauma: a tertiary care experience

2018 ◽  
Vol 5 (3) ◽  
pp. 975
Author(s):  
Vikram Trehan ◽  
Sukumar S. Kumar
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Tertiary Care ◽  
Hemodynamic Instability ◽  
Morbidity And Mortality ◽  
Organ Injury ◽  
Solid Organ ◽  
Care Hospital ◽  
Management Options ◽  
Solid Organ Injury

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. 

scholarly journals Focused abdominal ultrasound for blunt trauma in an emergency department without advanced imaging or on-site surgical capability

CJEM ◽  
2004 ◽  
Vol 6 (06) ◽  
pp. 408-415 ◽  
Author(s):  
Michael Shuster ◽  
Riyad B. Abu-Laban ◽  
Jeff Boyd ◽  
Charles Gauthier ◽  
Sandra Mergler ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Tertiary Care ◽  
False Negative ◽  
Rural Hospital ◽  
Definitive Treatment ◽  
Clinical Indication ◽  
Emergency Physicians ◽  
Advanced Imaging ◽  
Predictive Values

ABSTRACT:Objectives:To determine whether focused abdominal sonogram for trauma (FAST) in a rural hospital provides information that prompts immediate transfer to a tertiary care facility for patients with blunt abdominal trauma who would otherwise be discharged or held for observation.Methods:Prior to the study, participating emergency physicians underwent a minimum of 30 hours of ultrasound training. All patients who presented with blunt abdominal trauma to our rural hospital between Mar. 1, 2002, and Apr. 30, 2003, were eligible for study. Following a history and physical examination, the emergency physician documented his or her disposition decision. A FAST was then performed, and the disposition reconsidered in light of the FAST results.Results:Sixty-seven FAST exams were performed on 65 patients. Three examinations (4.5%) were true-positive (95% confidence interval [CI] 0.9%–12.5%); 60 (89.6%) were true-negative (95% CI 79.7%–95.7%), 4 (6%) were false-negative (95% CI 1.7%–14.6%) and none (0%) were false-positive (95% CI 0%–5.4%). These values reflect sensitivity, specificity, negative predictive value and positive predictive values of 43%, 100%, 94% and 100% respectively. FAST results did not alter the decision to transfer any patient (0%: 95% CI 0.0%–5.4%), although one positive FAST may have led to an expedited transfer. One of 38 patients who was discharged after a negative FAST study returned 24 hours later because of worsening symptoms, and was ultimately found to have splenic and pancreatic injuries.Conclusions:This study failed to demonstrate that FAST improves disposition decisions for patients with blunt abdominal trauma who are evaluated in a hospital without advanced imaging or on-site surgical capability. However, the study is not sufficiently powered to rule out a role for FAST in these circumstances, and our data suggest that up to 5.4% of transfer decisions could be influenced by FAST. Rural emergency physicians should not allow a negative FAST study to override a clinical indication for transfer to a trauma centre; however, positive FAST studies can be used to accelerate transfer for definitive treatment.

Clinical study of blunt abdominal trauma in patients at a tertiary care hospital

2019 ◽  
Vol 11 (3) ◽  
pp. 180-183
Author(s):  
Akshay Vasantrao Kulkarni ◽  
◽  
Milind Ramdas Patil ◽  
Keyword(s):  
Clinical Study ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

scholarly journals A PROSPECTIVE STUDY ON CLINICAL PROFILE, DIAGNOSIS AND MANAGEMENT OF BLUNT TRAUMA ABDOMEN IN A TERTIARY CARE HOSPITAL

2020 ◽  
pp. 1-3
Author(s):  
Kaushik Mandal ◽  
Anirban Bhunia
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Motor Vehicle ◽  
Road Traffic ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Gelatin Sponge ◽  
Care Hospital ◽  
Diagnosis And Management ◽  
Study Results

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%.

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