scholarly journals SPECTRUM AND OUTCOME OF BLUNT ABDOMINAL TRAUMA IN A TEACHING HOSPITAL, BIKANER, RAJASTHAN

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Surendra Saini ◽  
Mahesh Joshi
Keyword(s):  
Liver Injury ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Splenic Injury ◽  
Road Traffic ◽  
Age Groups ◽  
Operative Management ◽  
Initial Assessment ◽  
Assessment And Treatment ◽  
Case Distribution

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. Methods: Hospital based prospective study conducted at Dept. of General Surgery, S.P.Medical College and P.B.M Hospital, Bikaner Results: Case distribution according to organ involved consisted of 27 cases of liver injury 25 of these cases were managed conservatively , and only two were operated.18 cases were of splenic injury 16 of which were managed conservatively and two underwent surgery.    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 SPECTRUM OF BLUNT ABDOMINAL TRAUMA

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Ajay Pal ◽  
Indira . ◽  
L. K. Kapil
Keyword(s):  
Liver Injury ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Traffic Accidents ◽  
Splenic Injury ◽  
Road Traffic ◽  
Age Groups ◽  
Operative Management ◽  
Initial Assessment ◽  
Cross Sectional

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. Methods: Hospital based cross-sectional study conducted at Trauma center and P.B.M Hospital, Bikaner Results: Distribution according to type of injury consisted of maximum cases, 86% of road traffic accidents 74 of which were male and 12 female. 10% cases were of fall from height, 6 were male and 4 female .Assault cases were 4%. Case distribution according to organ involved consisted of 54.00% cases of liver injury,18.00% cases were of splenic injury, 23.00% patients had ilial injury, Pancreatic injury occurred in 2patient. 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 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.

scholarly journals Management modalities of isolated liver injury in blunt abdominal trauma

2019 ◽  
Vol 7 (1) ◽  
pp. 58
Author(s):  
Lalji Mangukiya ◽  
Hardik Astik
Keyword(s):  
Liver Injury ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Road Traffic ◽  
Demographic Data ◽  
Standard Of Care ◽  
Operative Management ◽  
Treatment Morbidity ◽  
Injury Grade ◽  
Isolated Liver

Background: The liver is one of the most commonly injured organ in blunt abdominal trauma. Management of liver injury due to blunt abdominal trauma has been dramatically evolved in recent years. Dramatic change from operative management to non-operative management has improved survival in these patients, becoming the standard of care for most liver injuries.Methods: A retrospective study of the patients admitted with the diagnosis of isolated liver injury due to blunt abdominal trauma between 2013-2018. Data collected of 30 patients of isolated liver injury who either treated conservative management of operative management. Variable analyzed included demographic data, mechanism of injury, associated injury, conservative treatment, operative treatment, morbidity, mortality, and hospital stay.Results: A total of 30 patients were analyzed of isolated liver injury due to blunt abdominal trauma, 27 patient sustained minor liver injury (grade I, II and III), whereas 3 patients had major liver injury (grade IV, V and VI). 25 cases due to road traffic accident and 5 cases were due to falls from a height. 27 patients with American Association for the surgery of trauma grade I, II, III and 2 patients with grade IV, V managed conservatively, surgical intervention required in 1 patient with grade V, mortality occurred in 1 patient out of 29 who were treated conservatively.Conclusions: Isolated liver injury is common in the blunt abdominal trauma patient. Most of the patients with the liver injury with hemodynamically stable treated conservatively. Only a few of them require surgical management if they are hemodynamically unstable.

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.

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.

Splenic artery embolization with N-butyl cyanoacrylate in patients with blunt abdominal trauma

Trauma ◽  
2021 ◽  
pp. 146040862110009
Author(s):  
Sreeja Sanampudi ◽  
Driss Raissi
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Splenic Artery ◽  
Splenic Injury ◽  
Medical Center ◽  
Operative Management ◽  
Splenic Trauma ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Technical Success Rate

Introduction Splenic artery embolization (SAE) has been shown to be safe and effective for non-operative management of patients with splenic trauma while preserving splenic function. A variety of coils, plugs, particles and liquid embolics have all been used. NBCA (n-butyl cyanoacrylate) is used less frequently than other modalities but is effective. Methods A retrospective review of all patients who underwent SAE with NBCA for blunt abdominal trauma at a single tertiary medical center over a six-year period. Results Out of 123 SAE patients, 7 utilized NBCA; 6 patients had intraparenchymal splenic artery pseudoaneurysms, 2 had intraparenchymal arteriovenous fistulas, and 5 had active extravasation from the spleen on CT imaging. There was 100% technical success rate. There were no acute post-op complications or complications at 30-day and 90-day follow up. One patient died 2 days following SAE secondary to worsening subdural hematoma unrelated to SAE. Conclusions NBCA is safe and effective in treating patients with splenic injury particularly in patients with high grade splenic injury demonstrating extensive intraparenchymal vascular injury and/or intraprocedural extravasation in distal locations.

scholarly journals A prospective and retrospective study on conservative management of hepatic and splenic injury following blunt abdominal trauma

2020 ◽  
Vol 7 (6) ◽  
pp. 1930
Author(s):  
Induchoodan Ponnamma Pillai Sukumaran Nair ◽  
Rajesh P. S.
Keyword(s):  
Abdominal Trauma ◽  
Conservative Management ◽  
Blunt Abdominal Trauma ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Road Traffic ◽  
Operative Management ◽  
Splenic Trauma ◽  
Solid Organ ◽  
Non Operative Management

Background: worldwide road traffic accidents accounts as the leading cause of death of young people. For a very long time most of the intra-abdominal injuries following blunt abdominal trauma were managed operatively. Conservative management is becoming more acceptable and effective management option for blunt abdominal trauma during the last few decades.Methods: This study was conducted in Government Medical College, Kottayam during September 2007 to December 2008. All conservatively managed blunt abdominal trauma patients during the study period were included in the study.Results: Out of 22 patients, 4 patients failed conservative management. Success rate was 81%. Most commonly injured solid organ in the study group was liver (77%). Maximum cases were of age group 10 to 20 (31.81%) years. 81% of patients were males. Motor vehicle accident was the most common cause of trauma (77%). Mean stay in intensive care unit was 4.2 days and mean hospital stay was 15.7 days. Mean systolic blood pressure was 110 mmHg ranging from 70 to 130 mmHg. 50% of patients had moderate hemoperitoneum and non-had massive hemoperitoneum.Conclusions: Non operative management is safe and effective approach in blunt spleen and liver injuries. Non operative management should be treatment of choice for all hemodynamically stable patients with blunt liver and splenic trauma.

scholarly journals Presentation and Management of Hepatic Injury due to Blunt Trauma in Patients Attending in Casualty Block of DMCH - A Study of 50 Cases

2018 ◽  
Vol 27 (1) ◽  
pp. 57-61
Author(s):  
Mohammad Mahfuzur Rahman Chowdhury ◽  
SM Amjad Hossain ◽  
Salma Sultana ◽  
Rifat Zaman ◽  
Md Alauddin ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Traffic Accidents ◽  
Hepatic Injury ◽  
Road Traffic ◽  
Operative Management ◽  
College Hospital ◽  
Medical College ◽  
History Of ◽  
Non Operative Management

Objective: To diagnose the cases of hepatic injury due to blunt abdominal trauma in a shortest possible time and find out the way of efficient and planned management of hepatic injury in our present setting. Materials and methods: This study was done in the casualty department of Dhaka Medical College Hospital and 50 patients of hepatic injury following blunt abdominal trauma were selected over a period of January 2010 to December 2010. All 50 patients were admitted within 24 hours of incidence. The patients were diagnosed clinically by history and physical examination and relevant investigations. Immediately after admission patients were resuscitated by clearance of airway, maintenance of respiration, arrest of external bleeding and maintenance of normal circulation (ATLS Protocol). After resuscitation further management was planned depending upon the condition of the patient. Clinical presentation, overall management and outcome were evaluated by the available resources of casualty ward of DMCH. Results: Most patients were male (88%) and 68% of patients were belonged to age group of 21 to 40 years. Most of the patients (90%) were injured as a result of road traffic accidents. All patients had a history of trauma and most of them presented with abdominal pain, tenderness muscular rigidity of abdomen and shock (38%). Only 13 (26%) patients had isolated hepatic injury. Rest of the patients had associated other organ injuries. Majority patients (46%) had Grade-I hepatic injury. Out of 50 patients, 46 were operated and most of them had other intra abdominal organ injuries and 4 patients were given non-operative management. Suture hepatorrhaphy was done in 38 (76%) cases. Most common post operative complications were pulmonary in origin (24%) and three patients were died in this series. Conclusion: Simple technique of hemostasis such as suture hepatorrhaphy is sufficient in most cases with adequate drainage and non operative management can be tried based on haemodynamic stability. J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 57-61

scholarly journals Non-operative Management of High-grade Renal Injuries in Children: A Review of Two Cases Seen at the Georgetown Public Hospital Corporation

2019 ◽  
pp. 23-24
Author(s):  
Andrea Kissoon ◽  
Marisa Seepersaud ◽  
Pradeep Ramkoomar
Keyword(s):  
Hospital Stay ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Renal Injury ◽  
Operative Management ◽  
Initial Assessment ◽  
High Grade ◽  
Average Hospital ◽  
Non Operative Management ◽  
Renal Injuries

Purpose:  Blunt abdominal trauma in children results in renal injury in approximately 10 to 20% of cases. In about 20% of these patients, significant complications may arise; for example urinoma (1%) and post trauma extravasation (2-18%). Urinomas and persistent hematuria were traditionally managed surgically by partial or total nephrectomy. Today, nonoperative management is well accepted for the majority of high grade renal injuries, as organ preservation is highly desirable due to patients’ projected lifespan. We present a retrospective review of two cases of high renal injuries seen at GPHC’s Paediatric Surgical Department. Methods: In February and April 2019, two patients met the criteria for grade four renal injury. All medical records were reviewed. Cause of injury, complications, interventions and hospital stay were analyzed. These patients were followed up post discharge, clinically and radiologically. Results: Two males, ages 11 and 10 years, sustained blunt abdominal trauma and presented to GPHC with hematuria and abdominal tenderness. On initial assessment, they were hemodynamically stable and were diagnosed with grade four renal injuries by computed tomography. Complications developed after one week of hospitalization. One patient had persistent hematuria lasting over a week, requiring blood transfusions in excess of 4 units, and the other developed a urinoma, urinary tract infection and deep vein thrombosis. Both patients had paralytic ileus and acute hypertension. These complications were all managed non operatively. The very large urinoma was successfully treated with percutaneous drainage after 25 days. Average hospital stay was 35 days and both patients had complete resolution of their renal injuries within 90 days post trauma. Conclusion: Non operative management of high-grade renal injury is highly successful and safe in children. Even in the presence of significant complications, preservation of renal tissue should be considered.

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