Spectrum of abdominal organ injury in a primary blast type

Abstract

IntroductionAbdominal organ injury in a primary blast type is always challenging for diagnosis. Air containing abdominal viscera is most vulnerable to effects of primary blast injury. In any patient exposed to a primary blast wave who presents with an acute abdomen, an abdominal organ injury is to be kept in a clinical suspicion.AimStudy various abdominal organ injuries occurring in a primary type of blast injury.Material and methods: All those who had exploratory laparotomy for abdominal organ injuries after a primary blast injury for a period of 10 years from January 1998 - January 2008 were included in this retrospective study.ResultsTotal 154 patients had laparotomy for abdominal organ injuries with a primary blast type of injury. Small intestine was damaged in 48 patients (31.1%) followed by spleen in 22.7% cases. 54 patients (35.06%) had more than one organ injured. Liver laceration was present in 30 patients (19.48%). Multiple small gut perforations were present in 37 patients (77.08%). Negative laparotomy was found in 5 patients (3.24%) whereas 3 (1.94%) had re-exploration. Mortality was present in 6 patients (3.89%).ConclusionsPrimary blast injury causes varied abdominal organ injuries. Single or multiple organ damage can be there. Small intestine is commonest viscera injured. Laparotomy gives final diagnosis.

Primary Repair of Traumatic Gut Injury Without Diversion in Casualty Department of Dhaka Medical College Hospital

“…Colon is one of the most commonly injured viscera followed by small gut and liver in abdomen for which management becomes complicated had the type and severity of injury not been assessed properly 4,5 . In primary repair of wound, researchers used several options of primary repair with or without colostomy to check the effectiveness of repair without diversion [6][7][8][9][10][11][12][13][14] . Similar types of intervention had been adopted in developing countries too [15][16] .…”

Pneumoperitoneum without visceral trauma: an under-recognised phenomenon after blast injury?

“…Pneumoperitoneum without visceral injury or violation of the peritoneum is unusual. Wani et al 5 conducted a retrospective study over a 10-year period of all those patients who underwent laprotomy after blast injury. Of 154 laparotomies, only 5 (3.24%) had no visceral injury.…”

Perforacion Traumatica Aislada De La Vesicula Biliar: Revision De La Literatura Actual Y Reporte De Un Caso

“…Posteriormente en 1984, Cox en una revisión de 5 años y 870 pacientes con trauma abdominal cerrado no encontró ninguna lesión de vesícula biliar aislada o asociada a otras lesiones de vísceras abdominales 4 . Revisiones recientes han establecido la incidencia de traumatismo de la vesícula biliar entre 2% y 6% de todos los casos que se presentan con trauma abdominal cerrado [5][6][7][8][9][10][11][12][13] . Habitualmente, la perforación traumática de la vesícula biliar ocurre en concomitancia con otras lesiones intraabdominales por lo que en muchos casos la presentación es tardía [9][10][11][12][13][14][15][16][17] .…”

“…La gravedad y el tipo de lesiones dependen de varios factores tales como la proximidad al sitio de la onda expansiva, la dirección e intensidad de la misma, la posición relativa del cuerpo y la parte del abdomen expuesta; y el efecto del contenido de la cavidad abdominal y del contenido de las vísceras. Los hallazgos clínicos son diversos y pueden encontrarse ausentes hasta el desarrollo de complicaciones 10,13 . El trauma de la vesícula biliar es raro, aun en grandes centros de referencia, Ball et al, en su reporte encontraron 45 (0,11%) lesiones de vesícula biliar en 40.000 pacientes y de ellas solo el 0,01% fueron PTAVB 8 .…”