Frequency, causes and pattern of abdominal trauma: A 4-year descriptive analysis

Arumugam, S.; Al-Hassani, Ammar; El‐Menyar, Ayman; Abdelrahman, Husham; Parchani, Ashok; Peralta, Rubén; Zarour, Ahmad; Al-Thani, Hassan

doi:10.4103/0974-2700.166590

Cited by 80 publications

(41 citation statements)

References 21 publications

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“… 30 A study conducted by Arumugam et al demonstrated that liver is the most common organ involved followed by the spleen. 31 Most of the traumas were managed conservatively and only a few patients were hemodynamically unstable and underwent emergency exploratory laparotomy, a result consistent with other research studies. 32 …”

Section: Discussionsupporting

confidence: 83%

Diagnostic performance of the extended focused assessment with sonography for trauma (EFAST) patients in a tertiary care hospital of Nepal

Basnet

Shrestha

Pradhan

et al. 2020

Trauma Surg Acute Care Open

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BackgroundThoracoabdominal trauma presents a diagnostic challenge for the emergency physician. The introduction of bedside ultrasonography (USG) provides a screening tool to detect hemoperitoneum, hemothorax, pneumothorax and pericardial effusion in torso injuries.AimTo evaluate the accuracy of extended focused assessment with sonography for trauma (EFAST) for chest and abdominal injuries performed by first responders in a tertiary care hospital of Nepal.MethodsThis was a prospective study including all trauma patients who obtained either an Injury Severity Score ≥15 or direct trauma to the trunk in 1 year period in the emergency department (ED) of Dhulikhel Hospital-Kathmandu University Hospital. The results of the EFAST were then compared with contrast-enhanced CT (CECT), radiology ultrasound (USG)/chest X-ray, or intraoperative findings when the EFAST was positive. The negative EFAST cases were observed for a minimum of 4 hours in the ED. Descriptive statistics and sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated.ResultsOut of 267 cases, 261 patients underwent an EFAST examination. The sensitivity and specificity were 94.8% and 99.5%, respectively. The negative predictive value was 98.53% whereas the positive predictive value was 98.21%. The overall accuracy was 99.4%.ConclusionThe results of this study suggest that EFAST examination performed by first-line healthcare providers is a useful method for assessment of thoracic and abdominal injuries. EFAST was found to have a high specificity (99.5%) and positive predictive value (98.21%) which indicates that it is an effective technique for detecting intra-abdominal or thoracic injuries. However, the effectiveness of EFAST is limited by its being operator dependent, and thereby human error. For negative EFAST cases, we recommend a monitoring period of at least 4 hours, serial fast scan, or further investigation through other methods such as a CECT.Level of evidenceLevel I

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Section: Discussionsupporting

confidence: 83%

Diagnostic performance of the extended focused assessment with sonography for trauma (EFAST) patients in a tertiary care hospital of Nepal

Basnet

Shrestha

Pradhan

et al. 2020

Trauma Surg Acute Care Open

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“…The overall median duration of hospital stay in the present study was 5.83 days which is lower than reported by Arumugan et al [1] and Chalya et al [6]. In comparison to other studies, mortality rates of 12.5% and 26% reported respectively by Musau P. et al [29] and Mohamed AA et al [30], overall mortality rate among abdominal trauma patients in our series was very low 2%.…”

Section: Discussioncontrasting

confidence: 65%

“…Trauma continues to be a major public health problem worldwide. Abdominal trauma (AT) is usually associated with high morbidity and mortality [1]. It may be blunt or penetrating and may involve damage to the abdominal organs.…”

Section: Introductionmentioning

confidence: 99%

Abdominal Trauma: Five Years Experience in National Centre Hospital, Mauritania

Idriss¹,

Tfeil²,

Baba³

et al. 2018

OJEM

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Trauma care including abdominal trauma is a big challenge. It is associated with high morbidity and mortality and continues to be a public health problem worldwide. The main aims of our study were to assess the patterns and outcomes of our patients, and to describe our experience in management of abdominal trauma. This descriptive retrospective study was conducted in general surgery department at National Centre Hospital of Nouakchott in Mauritania. We recruited patients presented at our department with abdominal trauma (2012-2016). Out of 100 cases, 92% were men. Mean age: 22.78 years (5-70 years). Eighty percent of patients suffered of penetrating abdominal trauma. Stab injuries were the most frequent mechanism (60%). The commonest organ injury was small intestine (16%). Mortality has been strongly related to road traffic accidents. Cares of severe abdominal traumas are not common in our hospital, due to lack of required overall data. Emergency health system is needed to better care of trauma patients in Mauritania.

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“…Hemodynamic instability is the primary indication for OM [ 14 , 17 , 18 ]. The objective of this study is to examine the prevalence, clinical presentation, management and outcomes of patients sustained blunt liver injuries in a small rapidly developing country in the Middle East.…”

Section: Introductionmentioning

confidence: 99%

Blunt liver trauma: a descriptive analysis from a level I trauma center

Afifi

Abayazeed²,

El‐Menyar

et al. 2018

BMC Surg

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BackgroundWe aimed to review liver injury experience in a level 1 trauma center; namely clinical presentation, grading, management approach and clinical outcomes.MethodsIt is a retrospective analysis to include all blunt liver injury patients who were admitted at the Level 1 trauma center over a 3-year period. Data were compared and analyzed based on the liver injury grades and management approaches.ResultsBlunt liver injury accounted for 38% of the total blunt abdominal trauma cases with a mean age of 31 ± 13 years. Liver injury grade II (44.7%) was most common followed by grade I (28.8%), grade III (19.1%), grade IV (7.0%) and grade V (0.4%). Blood transfusion was more frequently required in patients with grade IV (p = 0.04). Out of 257 patients with blunt liver trauma, 198 were initially treated conservatively, that was successful in 192 (97%), whereas it failed in 6 (3%) patients due to delayed bleeding from hepatic hematoma, associated splenic rupture and small bowel injury which mandate surgical intervention. Fifty-nine patients (23%) underwent emergent surgery in terms of packing, resection debridement, left lobe hepatectomy and splenectomy. Hepatic complications included biloma, pseudoaneurysm and massive liver necrosis. Subanalysis of data using the World Society of Emergency Surgery (WSES) classification revealed 19 patients were categorized as a WSES grade IV who needed surgical intervention without having an initial computerized tomography scanning. The overall mortality was 7.8% which was comparable among the conservative and operative group.ConclusionsIn our center, low grade liver injury in young males prevails. NOM is successful even for high graded injuries. All conservatively treated patients with high-grade liver injuries should be closely monitored for signs of failure of the non-operative management. Introducing the new WSES classification makes clear how is important the hemodynamic status of the patients despite the lesion. However, further larger prospective and multicenter studies are needed to support our findings.

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Frequency, causes and pattern of abdominal trauma: A 4-year descriptive analysis

Cited by 80 publications

References 21 publications

Diagnostic performance of the extended focused assessment with sonography for trauma (EFAST) patients in a tertiary care hospital of Nepal

Diagnostic performance of the extended focused assessment with sonography for trauma (EFAST) patients in a tertiary care hospital of Nepal

Abdominal Trauma: Five Years Experience in National Centre Hospital, Mauritania

Blunt liver trauma: a descriptive analysis from a level I trauma center

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