Blunt Abdominal Trauma: The Importance of Clinical Signs for Early Detection of Jejunal Rupture

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.

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

TAJ Journal of Teachers Association ◽

10.3329/taj.v28i2.39073 ◽

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

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BLUNT ABDOMINAL TRAUMA WITH HAEMOPERITONEUM TREATED BY EXPLORATORY LAPAROTOMY VERSUS ONLY ABDOMINAL DRAINAGE: A PROSPECTIVE AND COMPARATIVE STUDY.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i1.842 ◽

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.

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