Blunt abdominal trauma: a tertiary care experience

Abstract

Background: Blunt abdominal trauma (BAT) is one of the common causes of admission in surgical ward in any hospital. It requires high level of suspicion, urgent evaluation and timely management to decrease morbidity and mortality. Aim of present study was to find out demographic details, causes of injury, management options and treatment outcomes of BAT.Methods: Retrospective study of cases of BAT was carried out at a tertiary care hospital of India spanning five years, between June 2012 to June 2017. Authors analyzed the demographic profile of the trauma victims, etiological factors of BAT, the abdominal organs involved, the treatment modalities adopted and the final outcome.Results: There were 231 cases of BAT. Most common age group was 11 to 30 years which accounted for 42.42% of the total. The study had 181 (78.35%) males and 50 (21.64%) females. Road traffic accident was the most common cause of BAT and it accounted for 67.97%. Liver (34.20%) was the most commonly involved organ followed by spleen (22.51%), bowel (15.58%), mesentery (8.23%), kidney (7.36%), pancreaticoduodenal injuries (3.46%) and diaphragm (3.46%). 56.71% underwent non-operative management (NOM), 3.90% underwent angio-embolization and 39.39% eventually required operative treatment. Mortality occurred in 31 patients (13.41%) because of septicemia, renal failure, shock, acute coronary event or respiratory complications.Conclusions: NOM for BAT was found to be successful in haemodynamically stable patient with solid organ injury. Along with sophisticated infrastructure like ultrasound or CT Scan, close supervision with repeated examination by a treating surgeon were the sheet anchors of NOM. Angio-embolization is a feasible modality of treatment in solid organ injury and can avoid surgery in an appropriate patient. Definitive indications for laparotomy were hemodynamic instability and perforation-peritonitis. Initial hemodynamic instability, haemorrhagic shock, and associated injuries influenced morbidity and mortality in BAT.

Blunt Abdominal Trauma among Patients Admitted to the Department of Surgery at a Tertiary Care Centre: A Descriptive Cross-sectional Study

“… 6 The abdomen is the third most commonly injured region affecting about 7-10% of trauma patients with almost 85% being blunt in nature which can be isolated or associated with other injuries. 7 Blunt abdominal trauma is one of the leading causes of morbidity and mortality in young adults commonly caused by road traffic accidents followed by falls from heights and assaults. 7 Depending on the velocity of injury the severity might be diverse, ranging from simple abdominal abrasions to life-threatening organ injury which needs prompt intervention and even with best efforts might even result in death.…”