Background: Blunt abdominal trauma (BAT), a common form of trauma, is one of the major causes of morbidity and mortality. The study was aimed at the study of spectrum of injuries to various intra-abdominal organs after blunt trauma and to ascertain cause/mode of BAT in a hospital of hilly locality of Shimla.Methods: A prospective study was designed to conduct in the department of Surgery, IGMC, Shimla, India during the period of one year from 1st June 2005 to 31st May 2006. A total of 30 patients who had sustained BAT with or without other associated injuries were selected. In all patient’s history was taken and detailed physical examination done while concomitant resuscitation was performed. Chest and abdominal radiographs were done in all patients.Results: BAT is a major cause of morbidity and mortality especially in young people in the 11-40 years’ age group. Males are affected more than females. Road traffic accidents are the predominant mode of injury however, a relatively high incidence of blunt abdominal trauma due to falls is observed in a hilly state like ours. Spleen and liver are the two commonly injured organs after blunt abdominal trauma.Conclusions: Proper early diagnosis with initial and adequate resuscitation is beneficial in having a good outcome in patients of BAT.

Background: Trauma in Himachal Pradesh is an increasingly significant problem, particularly in light of rapid development and increasing motorization. In the state of Himachal due to the predominantly hilly terrain people are more vulnerable to accidents, resulting in various injuries. Moreover, an increase in industrialization, ongoing construction of hydel projects and subsequent increase in accidents have also affected an increase in the incidence of trauma. Social and environmental changes are resulting in alterations in epidemiology of trauma. The present study was done to study the pattern, cause, mode and burden of trauma in patients presenting to IGMC Shimla.Methods: This prospective study was done on 4267 patients of trauma admitted to various departments of IGMC, Shimla during the period from June 2014 to May 2015. Detailed history of the patient, mode of injury was collected. Complete trauma profile and blood investigations were done in all patients. Postmortem findings of the trauma victims who died in IGMC or who were brought dead due to trauma were recorded. Results: The mean age of the patients in the study was 33.56 years. Male preponderance was noted (M:F-2.7:1). The commonest mode of injury was due to fall (75.60%). Of the total, 72.39% patients admitted with isolated injuries confined to one particular region, 11.72% patients with multiple injuries with in a single region, 13.01% patients with polytrauma, and 2.44% patients with burns. The rate of mortality was 2.06% (n=88).Conclusions: Improved infrastructure, behavior patterns of the individuals, can decrease the rate of trauma in the state. Development of strong and supportive management policies by the emergency departments in hospitals can reduce the mortality rate related with trauma.

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Aim:To evaluate the efficacy of nonoperative treatment in blunt trauma liver. Materials and methods:A 1-year prospective study was conducted in the Department of Surgery, Indira Gandhi Medical College (IGMC), Shimla, Himachal Pradesh, India, on 31 patients with blunt trauma with liver injuries proved on ultrasonography (USG) focused assessment with sonography for trauma (FAST) and contrast-enhanced computed tomography (CECT) abdomen. Once admitted, patients with grades I or II liver injury with no other comorbidities and other associated injuries were managed conservatively. Patients with grades III, IV, or V liver injury or lower grade liver injury with other associated injuries were observed and monitored strictly. Patients were considered a failure if the patient developed signs of peritonitis. Results:Out of 83 patients with blunt abdominal trauma, 31 patients fulfilled the inclusion criteria for nonoperative management (NOM). The incidence of blunt liver trauma (BLT) was 37.34% Out of these, one patient required operative management (OM). Average age was 27 years. Out of 31 patients, 25 (80.6%) patients were males and 6 (19.4%) were females. Totally, 24 (77.4%) patients acquired injury due to road side accidents. Totally, 25 (80.6%) patients reported to the hospital within 6 hours of injury and 5 (16.1%) within 7 to 12 hours. On grading of liver injuries depending on CECT findings, 6 (19.4%) patients presented with grade I injury, 7 (22.6%) patients with grade II injury, 11 (35.5%) with grade III injury, and 6 (19.4%) with grade IV injury. Grade V injury was noted in 1 (3.2%) patient. Sixteen patients required blood transfusion. The NOM was successful in 96.8% of the patients. Liver-specific success rate of NOM was 100%. Mean hospital stay was 10.8 days for NOM. Conclusion:Patients of blunt liver injury who are hemodynamically stable should be considered for NOM. Clinical significance:The NOM is a highly feasible and safe method for being cost-effective, requiring shorter hospital stay, and avoiding high morbidity.