Intra-abdominal Abscess After Blunt Abdominal Trauma

Abstract

The relationship between blunt abdominal trauma and intra-abdominal abscess (IAA) is discussed infrequently; therefore we conducted a retrospective review of 4050 multiple blunt trauma admissions from January 1986 to July 1988. Of 325 patients who had a laparotomy for blunt abdominal trauma, we identified 15 (4.6%) who had 40 IAAs. The most common intra-abdominal injuries involved the spleen and liver. Splenectomy increased the risk for IAA in contrast to splenic salvage. Blunt injuries to the kidney and pancreas, when occurring in multiple trauma patients, carried a significant risk of IAA. Associated multiple extra-abdominal injuries and high transfusion requirements increased the risk for IAA formation. Most of the IAAs were located in the upper quadrants. There was a 46% incidence of multiple IAA, which in turn had an 80% chance of recurrence after initial drainage. Enterobacter species played an important role in the formation of IAA in our trauma patients. Three patients (20%) died. Poor prognostic indicators included a high injury severity score, high transfusion requirements, the presence of pelvic fracture, positive blood cultures, multiple organisms per abscess, and multiple-organ system failure.

Splenic injury: a clinical study and management in a tertiary care hospital

“…Changlani 40%, Powel and Colleagues 67%, R. Khanna et al 52%. [8][9][10][11][12] Clinical features: Symptoms: Abdominal pain was the symptom present in 56.66% of cases (17 patients). Pain varied from mild to severe.…”

Fatal blunt pancreatic trauma secondary to assault and battery: a case report

“…They mainly result from traffic accidents, however several authors point out that pancreatic lesions can be a consequence of physical violence [8,11,12,13].…”

“…Such complications would be responsible for a death rate of more than 20% [22]. On the contrary, according to several authors an isolated trauma of the pancreas cannot be responsible for a rapid death [12,22,23], but can result in numerous complications (19-25% of cases) [11,13], mainly fistular and also acute pancreatitis and abcesses, with a rate of delayed death estimated at 9% [19,23]. These complications can be explained by the occurrence of a necrosis of the gland by its own enzymes, linked to a parenchymatous rupture affecting the acini, or to a rupture of a duct.…”

A Randomized Controlled Trial on Intra-Abdominal Irrigation during Emergency Trauma Laparotomy; Time for Yet Another Paradigm Shift

“…at the time of the original sample calculation) English biomedical literature to query the known incidence of the complications of interest after a trauma laparotomy which could be theoretically preventable by the use of abdominal irrigation [12][13][14][15][16][17][18][19][20], and cross referenced with current literature for continued relevancy ( Table 1). The compiled risks of incidence were then used to make the calculation, using a power of 80% and twosided 5% significance level (and aiming for clinical superiority), performing a Bonferroni adjustment for three comparisons per variable, and selecting the largest (which was abscess formation) resulting in a sample size of 68 subjects per arm (after adjustments for possible 2% crossover between groups).…”