scholarly journals Isolated jejunal perforation - hidden danger in blunt abdominal trauma

2021 ◽  
pp. 75-75
Author(s):  
Krstina Doklestic ◽  
Dragan Vasin ◽  
Bojan Jovanovic ◽  
Dzemail Detanac ◽  
Ivana Lesevic
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Road Traffic ◽  
Bowel Perforation ◽  
Clinical Signs ◽  
Diagnostic Procedures ◽  
Initial Examination ◽  
Adequate Treatment ◽  
Short Period

Introduction. Isolated jejunal perforation (IJP) without any associated injuries is rare in blunt abdominal trauma (BAT). It most commonly occurs in decelerating trauma. Diagnosis of traumatic intestinal perforation may be difficult in the first hours after injury so unrecognized ?missing? intestinal injuries incidences are as high as 24%. Unrecognized traumatic bowel perforation without adequate treatment leads to the intestinal leakage into the peritoneal cavity, making progress in secondary peritonitis and potentially lethal complications. Case outline. We presented the case of 43 years old women injured in road traffic accident. She was admitted to emergency surgery after diagnostic procedures according to the protocol for trauma. Initial examination, and body computed tomography (CT) revealed orthopedic injuries. Daily monitoring and follow-up examinations were done, she did not complain of any discomfort nor pain in the abdomen and there were no signs of abdominal injury. Two days after trauma, follow-up abdominal CT revealed highly suspected jejunum perforation, still with no signs of pneumoperitoneum. Laparotomy was performed and diagnosis of IJP was confirmed. Bowel perforation was surgically closed in two layers, followed by drainage of septic collections, abdominal saline lavage and primary abdominal closure. The patient was discharged on the seventh postoperative day without complications. Conclusion. In the case of BAT due to severe traumatic force in patient with nonspecific clinical signs of abdominal trauma on initial clinical and radiological examination, follow-up in a short period is necessary, to detect hidden jejunal perforation. Surgery is a life-saving for those patients and treatment of these injuries usually require simple operative procedures.

scholarly journals Intra- Abdominal Injuries Following Blunt Abdominal Trauma-Analysis of 100 cases.

2018 ◽  
Vol 28 (2) ◽  
pp. 7-14
Author(s):  
MM Sarker ◽  
MK Sarker ◽  
NA Perveen
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Road Traffic ◽  
Clinical Signs ◽  
Total Mortality ◽  
Active Phase ◽  
Abdominal Injuries ◽  
Hollow Viscus ◽  
Erect Posture ◽  
Negative Laparotomy

With the advent of industrialization, accelerated social violence, increasing road traffic accident and increasing use of machineries trauma has become the leading cause of mortality and disability. Considering trauma abdominal trauma is one where early diagnosis and accurate assessment and timely intervention can save the life of the victim in most of the instances. This is a prospective observational study that represents the experience of 100 consecutive patients of blunt abdominal trauma with suspected intra-abdominal injuries admitted in surgical words of RMCH, Rajshahi. The most of the patients were male (87%) and in active phase of life. RTA (53%) was the most common cause of blunt abdominal trauma and majority of the patients (38%) arrived in the hospital within 7-24 hours. Major clinical signs of intra-abdominal injuries were signs of peritonitis. The main investigation done was plain X-ray abdomen (71%) in erect posture, of which 55% cases showed free gas under the done of the diaphragm. Out of 100 cases 77 patients were operated upon and 23 patients were managed conservatively. The incidence of hollow viscus injury (57%) was higher than solid organs (36%) injury but only five patients came out to be a negative laparotomy. Of all operated cases fifty one were recovered uneventfully and only twenty three patients developed various postoperative complications. The most of the patients (40%) left the hospital within 11-14 days. Seven patients died on the day of admission but total mortality was nine (9%) in number.TAJ 2015; 28(2): 7-14

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 SPECTRUM AND OUTCOME OF BLUNT ABDOMINAL TRAUMA

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Mahesh Kumar Sharma ◽  
Dr. Arun Bhargava
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Traffic Accident ◽  
Traffic Accidents ◽  
Splenic Injury ◽  
Road Traffic ◽  
Age Groups ◽  
Operative Management ◽  
Fall From Height ◽  
Type Of Injury

Background: Blunt abdominal trauma is a leading cause of morbidity and mortality among all age groups. So we evaluate the spectrum and outcome of blunt trauma. Methods: Hospital based prospective study conducted on 100 patients at department of general surgery. Results: Distribution according to type of injury consisted of maximum cases, 84 (84%) of road traffic accidents, 11% cases were of fall from height. 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. Keywords: Blunt abdominal trauma, Liver injury, Perforation, Splenic injury

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.

The Role of Follow-up Imaging in Paediatric Blunt Abdominal Trauma

2002 ◽  
Vol 57 (10) ◽  
pp. 908-912 ◽  
Author(s):  
A Mizzi ◽  
A Shabani ◽  
A Watt
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma

scholarly journals Delayed jejunal perforation following blunt abdominal trauma

2010 ◽  
Vol 92 (2) ◽  
pp. e23-e24 ◽  
Author(s):  
Vijay Subramanian ◽  
Ravish Sanghi Raju ◽  
Frederick Lorence Vyas ◽  
Philip Joseph ◽  
Venkatramani Sitaram
Keyword(s):  
Small Bowel ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Bowel Perforation ◽  
Blunt Injury ◽  
Small Bowel Perforation

Jejunal perforation is a known complication of abdominal trauma. We report two cases of jejunal perforation presenting nearly 2 months following blunt injury to the abdomen and discuss possible mechanisms for delayed small bowel perforation.

scholarly journals Laparoscopic Treatment of Splenic Injury in Blunt Abdominal Trauma

2013 ◽  
Vol 2 (3) ◽  
pp. 112-115 ◽  
Author(s):  
Ali I Yahya ◽  
Hussen E Shwerief ◽  
Rifat Latifi ◽  
Najala E Endaha ◽  
Fatma O Algyead
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Medical Records ◽  
Traffic Accidents ◽  
Splenic Injury ◽  
Road Traffic ◽  
Splenic Trauma ◽  
Road Traffic Accidents ◽  
Laparoscopic Treatment ◽  
Trauma Unit

ABSTRACT Introduction Road traffic accidents are very common and pose a serious community problem in Libya. In 1998, the surgery unit at Zliten Teaching Hospital began using laparoscopy in the trauma unit for patients who were admitted to intensive care unit. A challenge for trauma surgeons is negative laparotomy which can result in increased complications for patients. Objective We reviewed medical records following the implementation of laparoscopic techniques in the trauma unit to determine the effectiveness of the treatment with patients who had been in road traffic accidents. Methods Review of medical records for patients admitted to Zliten General Hospital in Libya who had been involved in road traffic accidents was conducted. The records analyzed were from 1998 through 2012. Results One hundred and twenty-four patients underwent diagnostic and therapeutic laparoscopy over the 14 years time period, of which 76 patients had blunt abdominal trauma. The review of Zliten's trauma registry shows that 18 patients had splenic trauma and those patients who had splenic trauma. Out of the 18 patients who had blunt splenic trauma, three patients underwent laparoscopic splenectomy because it was not possible to preserve the spleen. One patient, aged 9 years, had an open laparotomy because the surgeons found that the spleen has avulsed completely and was lying at the left iliac fossa during diagnostic laparoscopy. Fourteen patients had small lacerations in the spleen. The spleen was not removed in these patients because profuse bleeding did not occur. No significant morbidity and no mortality were recorded. The hospital stay was between 2 and 5 days. Conclusion By using laparoscopy in trauma, we were able to preserve the spleen in the majority of our patients with splenic injuries who were hemodinamically stable. How to cite this article Yahya AI, Shwerief HE, Latifi R, Endaha NE, Algyead FO. Laparoscopic Treatment of Splenic Injury in Blunt Abdominal Trauma. J Trauma Critical Care Emerg Surg 2013;2(3):112-115.

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.

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