A Study on Trauma Mechanisms and Injury Sites in Patients with Blunt Abdominal Trauma

Abstract

Background. Although blunt abdominal trauma is sometimes readily identified in patients with trauma, its diagnosis and treatment can be delayed due to various limitations including unconsciousness or unstable vital functions, which may cause shock due to blood loss and sepsis. Confirming the correlation between the specific damage of the abdominal organ and the recommended surgical intervention will allow for predicting abdominal damage based on the specific underlying trauma mechanisms. Objectives. This study aimed to assess the proportion of patients with blunt trauma resulting from intraabdominal injury who received surgical intervention (surgery and angioembolization [A/E]), stratified by trauma mechanism and to examine which organs were damaged per different trauma incident. Methods. We retrospectively analyzed the clinical characteristics of 2,291 patients in a tertiary trauma center. Clinical characteristics included age, sex, injury severity score, trauma mechanism (car, motorcycle, pedestrian, bicycle, ship or train accident, fall, slipping or rolling down, bumping, crush injury, explosion burn, and others), abdominal surgical intervention, damaged organ, and A/E site. Results. One-fourth of the patients with blunt trauma required surgical intervention in the abdomen. In particular, the mesentery or bowel was the main injured area for abdominal surgery in all mechanisms, and the spleen or liver was the main damaged organ subjected to A/E. Therefore, we should consider that a substantial proportion of patients with trauma do require abdominal surgery. In particular, repeated physical examination and imaging tests are necessary when the patients are unconscious or their vital functions are unstable for accurate confirmation of injury.

Patterns and outcomes of patients with abdominal injury: a multicenter study from Iran

“…In the United States (US) and Korea, road-related accidents (including bicycle, pedestrian, motorcycle) were the leading cause of blunt abdominal injury [9,10]. Other causes include falls, sports injuries, and industrial accidents.…”

“…Although the outcome of patients with blunt abdominal injury has improved in the last two decades, in patients with multiple organ injuries, the in-hospital mortality rate was reported as 3-10% [10]. Also, according to reports, about 90% of abdominal injuries are blunt [5,9,11]. Penetrating abdominal injury is usually caused by stabs and gunshots; most organs damaged in this type include the small intestine, large intestine, liver, and intra-abdominal vessels.…”