DOI: http://dx.doi.org/10.18203/2349-2902.isj20183200

Outcome of gastrointestinal perforations due to blunt abdominal trauma

Anubhav Goel, Ankur Bansal, Bhupesh Gogia

Abstract


Background: The most common injury during blunt abdominal trauma (BAT) is of solid organs. Hollow viscus injuries are much more uncommon compared to the non-hollow ones. The most important problem associated with these conditions that they are frequently remain undetected or diagnosed too late despite advanced techniques such as focussed abdominal sonography for trauma (FAST), computer tomography, and magnetic resonance imaging. This study evaluates gastrointestinal perforation following blunt abdominal trauma, their anatomical distribution, diagnosis, management, and outcome.

Methods: The study was a prospective observational study conducted after ethical clearance from hospital. The patients included were those presenting with features of peritonitis following blunt trauma, with isolated injury to abdomen and found to exhibit gastrointestinal perforation on exploratory laparotomy. Exclusion criteria were perforation was not detected at surgery, penetrating abdominal trauma. Data of each patient were collected into the Performa prepared for the study.

Results: During the study period, 32 patients underwent surgery for perforation following blunt abdominal trauma. Jejunum was the most common site of perforation in the study subjects followed by ileum than stomach. Among the procedures performed, simple closure of perforation with peritoneal lavage was the most commonly performed procedure in 24 patients (75.0%). Resection anastomosis was done in 3 (9.3%) cases, while stoma was fashioned in 5 (15.6%) patients. 5 (15.6%) patients developed complications in the postoperative period with chest infection being the most common. One patient died in the postoperative period leading to mortality rate of 3.1%.

Conclusions: To conclude, early diagnosis and treatment are of utmost importance. Most common site for perforation in blunt trauma is jejunum. Early surgery following adequate resuscitation in gastrointestinal perforation following blunt trauma abdomen is associated with a very a good outcome.


Keywords


Blunt trauma, Laparotomy, Perforations

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