Predictors of "occult" intra-abdominal injuries in blunt trauma patients

Parreira, José Gustavo; Malpaga, Juliano Mangini Dias; Olliari, Camilla Bilac; Perlingeiro, Jacqueline Arantes Gianninni; Soldá, Silvia Cristine; Assef, José Cesar

doi:10.1590/0100-69912015005008

Cited by 9 publications

(4 citation statements)

References 24 publications

(40 reference statements)

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“…Hollow viscous injury was less than solid organ injury. The ndings of this study were similar as reported by Parreira et al (2015) and Mehta et al (2014). While Ravikanth et al (2015) found liver injury (26%) more than splenic injury (20%).…”

Section: Discussionsupporting

confidence: 90%

A Clinical Study of Blunt Traumaabdomen With Respect to Management and Outcome at Gmc, Bettiah, Bihar

Kumari¹,

Reyaz²,

Narayan³

et al. 2020

ijsr

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Background: Following injury to the extremities and head, abdomen is the third most commonly injured part of the body. Blunt abdominal trauma (BAT) is particularly deceptive because of the delay in clinical manifestations for hours or even days, even though the damage to the internal organs might be serious and lethal. Road traffic accident (RTA) is the most common mode of injury to cause BAT. Diagnostic modalities like FAST and CT scans have caused a significant change in the trends regarding management from surgical to a more conservative approach. Current research aimed to study the blunt trauma abdomen with respect to management and outcome in GMC, Bettiah, W. Champaran, Bihar. Material and methods: This observational study is based on 50 cases of BAT who presented in Department of Surgery, Govt. Medical College & Hospital, Bettiah, Bihar with respect to clinical presentation, investigations, management and outcome. Results and outcomes will be depicted in various tables. Results: In the present study, demographic data like age and sex, the mode of injury, presenting Hb (in gm%), commonly injured organs, the management done and the associated mortality was observed and compared. It was found that BAT commonly involves young males in the age group of 30-40 years. RTA is found to be the most common mode of injury. Spleen was the most commonly injured solid organ followed by liver. Hollow viscus injury was seen in 10 out of 50 patients in our study. Conservative management was done in 37 out of 50 patients. Mortality was observed in 3 out of 50 cases. Conclusion: The study was conclusive of the fact that young males who sustained BAT due to RTA were the most commonly affected group. It also was conclusive that spleen and liver are the most commonly injured organs in BAT and conservative management should be followed wherever possible. Mortality was significantly higher in patient presenting with decreased hemoglobin.

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Section: Discussionsupporting

confidence: 90%

A Clinical Study of Blunt Traumaabdomen With Respect to Management and Outcome at Gmc, Bettiah, Bihar

Kumari¹,

Reyaz²,

Narayan³

et al. 2020

ijsr

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“…13 Other studies have reported spleen to be the most injured organ in BAT followed by liver, as has been shown by Parreira et al (45.3% and 44%) and Mehta et al (53% and 35%). 14,6 Other solid organ injuries authors observed were kidney (7.36%) and pancreas (3.46%). Authors found hollow viscus injuries in 15.58% of BAT.…”

Section: Discussionmentioning

confidence: 95%

Blunt abdominal trauma: a tertiary care experience

Trehan¹,

Kumar²

2018

Int Surg J

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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.

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“…At the Alfred Health, Melbourne, Australia, we routinely perform split dual-bolus intravenous contrast-enhanced CT with single acquisition through the chest, abdomen, and pelvis to capture both the arterial and portal venous phases in patients with severe trauma. This CT protocol is commonly used for patients involved in MVAs, as this mechanism is associated with a high frequency of severe traumatic injuries to the chest, abdomen and pelvis [ 4 ]. The protocol is customized based on the specific mechanism and pattern of injury obtained from the clinical history ( Table 1 ).…”

Section: Radiology Decision-makingmentioning

confidence: 99%

“…A recent study by Parreira et al [ 4 ] has found that analysis of the trauma mechanism enables accurate prediction of the possible injuries to investigate. This information can be used not only for streamlining investigations and reducing the number of diagnostic tests with negative results, but also for triaging patients to ensure the most appropriate treatment.…”

Section: Introductionmentioning

confidence: 99%