Compartmental anatomical classification of traumatic abdominal injuries from the academic point of view and its potential clinical implication

Abstract

BackgroundThe mechanism and outcome of traumatic abdominal injury (TAI) varies worldwide. Moreover, data comparing TAIs in each abdominal compartment are lacking. We aimed to assess from the academic point of view, TAI based on its anatomical compartments.Patients & methodsWe conducted a retrospective study for TAI patients between 2008 and 2011 in Qatar. Patients were categorized according to the involved anatomical compartment (C): intrathoracic (ITC), retroperitoneal (RPC), true abdomen (TAC), and pelvic abdomen (PAC) group. Chi Square test, One-Way ANOVA and multivariate regression analysis were appropriately performed.ResultsOf 6,888 patients admitted to the trauma unit, 1,036 (15%) had TAI that were grouped as ITC (65%), RPC (15%), TAC (13%), and PAC (7%). The mean age was lowest in ITC (29 ± 13) and highest in TAC (34 ± 11) group, (P = 0.001). Motor vehicle crash was the main mechanism of injury in all groups except for PAC, in which fall dominated. Vast majority of expatriates had PAC and TAC injuries. The main abdominal injuries included liver (35%; ITC), spleen (32%; ITC) and kidneys (18%; RPC). Extra-abdominal injuries involved the head in RPC and ITC, lung in ITC and RPC and extremities in PAC. Mean ISS was higher in RPC and ITC. Abdominal AIS was higher in TAC injuries. Overall hospital mortality was 10%: RPC (15%), TAC (11%), ITC (9.4%) and PAC (1.5%). Concurrent traumatic brain injury (OR 5.3; P = 0.001) and need for blood transfusion (OR 3.03; P = 0.003) were the main independent predictors of mortality.ConclusionIn addition to its academic value, the anatomical approach of TAI would be a complementary tool for better understanding and prediction of the pattern and outcome of TAI. This would be possible if further research find accurate, early diagnostic tool for this anatomical classification.

Aspects Épidémiologiques, Diagnostiques Et Thérapeutiques Des Traumatismes Abdominaux À Bembéréké-Nord Bénin

“…Cette prédominance s'explique par l'activité socioprofessionnelle faisant que les hommes sont plus exposés que les femmes. La prédominance masculine est conforme à la littérature : (Gad 2012, Harouna 2001, Allode 2011, Mnguni 2012, Groven 2012, Pekkari 2014, El-Menyar 2014…”

“…Etiologies: Les circonstances de TA décrites dans la littérature étaient retrouvées dans la série. Les accidents de circulation prédominent avec 33,63% des étiologies (Gad 2012, Harouna 2001, Pekkari 2014, El-Menyar 2014. Dans la série, la particularité du milieu rural (agro-pastoral) est la fréquence élevée de TA d'origine animale (27,55%) et après chute du haut d'un arbre (14,29%).…”

“…Les contusions représentaient 74,50% et les plaies, 25,50 % des cas. La prédominance des contusions est rapportée dans plusieurs études dans les mêmes proportions (Gad 2012, Harouna 2001, Allode 2011, El-Menyar 2014, Hemmati 2013, Ayite 1996 Par contre, Gaudeuille en Centrafrique et Mnguni à Durban en Afrique du Sud avaient trouvé respectivement 75% et 90,2% de plaies dues à la fréquence des agressions par arme blanche et à feu dans les grandes agglomérations (Gaudeuille 2007, Mnguni 2012.…”

“…Les organes pleins (rate, foie, reins) sont les plus atteints surtout dans les contusions. Ce constat est conforme à la littérature (Pailler 1991, Harouna 2001, Allode 2011, Sani 2004, Pekkari 2014, Menyar 2014 Les organes creux (grêle, colon, vessie) étaient les seuls lésés en cas de plaies abdominales. D'autres études confirment la prédominence d'atteinte des viscères creux dans les plaies abdominales (Allode 2011, Madiba 2012, Gaudeuille 2007, Bâ 2013.…”

Role of Neutrophil-to-Lymphocyte Ratio as a Predictor of Systemic Inflammatory Response Syndrome in Blunt Abdominal Trauma Following Emergency Laparotomy in Sanglah General Hospital, Denpasar

“…Abdominal trauma, both blunt and penetrating trauma, is the third most common trauma, which is about 10% after head trauma (30%) and chest trauma (20%) [1]. Management of trauma patients, especially those related to preventing blood loss and coagulopathy, significantly reduced the mortality ratio directly related to trauma.…”