An Experience with Blunt Abdominal Trauma: Evaluation, Management and Outcome

Abstract

Blunt abdominal trauma (BAT) is a frequent emergency and is associated with significant morbidity and mortality in spite of improved recognition, diagnosis and management. Trauma is the second largest cause of disease accounting for 16% of global burden. The World Health Organization estimates that, by 2020, trauma will be the first or second leading cause of years of productive life lost for the entire world population. This study endeavors to evaluate 71 cases of BAT with stress on early diagnosis and management, increase use of non operative management, and time of presentation of patients. A retrospective analysis of 71 patients of BAT who were admitted in Kempegowda Institute of Medical Sciences hospital (KIMS, Bangalore, India) within a span of 18 months was done. Demographic data, mechanism of trauma, management and outcomes were studied. Most of the patients in our study were in the age group of 21-30 years with an M:F ratio of 3.7:1. Motor vehicle accident (53%) was the most common mechanism of injury. Spleen (53%) was the commonest organ injured and the most common surgery performed was splenectomy (30%). Most common extra abdominal injury was rib fracture in 20%. Mortality rate was 4%. Wound sepsis (13%) was the commonest complication. Initial resuscitation measures, thorough clinical examination and correct diagnosis forms the most vital part of management. 70% of splenic, liver and renal injuries can be managed conservatively where as hollow organs need laparotomy in most of the cases. The time of presentation of patients has a lot to do with outcome. Early diagnosis and prompt treatment can save many lives.

Traumatic abdominal injuries: our experience at rural tertiary care center

“…Stab injury (18%) was the commonest etiology for penetrating trauma. Similar findings were also reported in the various other national studies 3,4,7,9,14,[18][19][20] and international studies. 6,[11][12][13] Bull horn injury to the abdomen was also seen in our region as it is surrounded by many villages.…”

“…Similar findings are also reported by various national and international studies. 3,9,14,15,21 Small bowel was the commonest hollow viscous injured in penetrating abdominal trauma in our study. These findings are in accordance with various national and international studies.…”

“…This observation (male predominance) was in accordance with other reported studies. [13][14][15] Male predominance seen in this study may be because mostly males are the earning members of the family and are most exposed to outdoor activities while the females are mostly engaged in household activities. Also males are more commonly involved in acts of violence.…”

“…These findings are almost consistent with the other studies. 3,9,14,16 Majority of patients (54%) in our study presented late i.e. 24 hours after injury.…”

Diagnostic and therapeutic potentials of laparoscopy in abdominal trauma

“…Травма является наиболее частой причиной смерти в возрастной категории от 1 года до 44 лет и уступает лишь онкозаболеваниям и атеросклерозу в структуре смертности для всех возрастных катего-рий [1][2][3][4]. По данным исследований ВОЗ, травма-тизм, преимущественно автодорожные травмы, сти-хийные бедствия и терроризм, могут стать основной причиной смерти к 2020 г.…”