A study of blunt and penetrating abdominal trauma, its various patterns of injuries, and its management

Abstract

Background: Abdominal trauma is one of the most common injuries among injuries caused mainly due to road traffic accidents. The rapid increase in motor vehicles and its aftermath has caused rapid increase in the number of victims to blunt abdominal trauma (BAT). Motor vehicle accidents account for 75%-80% of BAT. The knowledge in the management of BAT is progressively increasing due to the inpatient data gathered from different parts of the world. In spite of the best techniques and advances in diagnostic and supportive care, the morbidity and mortality remains at large. The reason of this could be due to the interval between trauma and hospitalization, delay in diagnosis, inadequate or lack of appropriate surgical treatment, postoperative complications, and associated trauma especially to spine, head, thorax, and extremities. Objective: To study the blunt and penetrating abdominal trauma, its various patterns of injuries, and its management. Materials and Methods: After initial resuscitation of the trauma victims, a careful history was taken to document any associated medical problem. Documentation of patients, which included identification, history, clinical findings, diagnostic test, operative findings, operative procedures, and complications during the stay in the hospital and during subsequent follow-up period, was recorded on a Performa specially prepared. The decision for operative or nonoperative management depended on the outcome of the clinical examination and results of diagnostic tests. Patients selected for nonoperative or conservative management were placed on strict bed rest and subjected to serial clinical examinations that included hourly pulse rate, blood pressure, respiratory rate, and repeated examination of abdomen and other systems. Result: The most common age group involved in BAT was between 13 and 20 years, whereas in penetrating abdominal trauma was between 21 and 30 years. This study showed that of 100 cases of abdominal trauma, 19 were presented with shock (blood pressure <100 mm Hg) while 30 had blood pressure between 100 and 110 mm Hg. Following BAT of 75 patients, 48 managed conservatively while 27 undergone operative management. Following penetrating abdominal trauma of 25 patients, only one managed conservative whereas all other required exploration. Conclusion: The best way of reducing the morbidity and mortality from BAT is prevention. There is an acute need of trauma center that is well equipped with all modern facilities in tertiary care center.

Comprehensive study of blunt injury abdomen in single center

“…5 Unrecognized intra-abdominal injury remains distressingly frequent cause for preventable death in a patient with blunt injury abdomen. 6 The aim of the study ABSTRACT Background: Blunt injury abdomen is the leading cause of morbidity and mortality in all age groups. Blunt trauma differs from penetrating trauma as different organs are characteristically injured by compression from blunt straining.…”