A study of role of non-operative management in blunt abdominal trauma with solid organ injury

Atish N. Bansod; Rohan Umalkar; Ambrish T. Shyamkuwar; Amar Singade; Priyanka Tayade; Neha Awachar

doi:10.18203/2349-2902.isj20183721

Authors

Atish N. Bansod Department of Surgery, IGGMC, Nagpur, Maharashtra, India
Rohan Umalkar Department of Surgery, IGGMC, Nagpur, Maharashtra, India
Ambrish T. Shyamkuwar Department of Surgery, IGGMC, Nagpur, Maharashtra, India
Amar Singade Department of Surgery, IGGMC, Nagpur, Maharashtra, India
Priyanka Tayade Department of Surgery, IGGMC, Nagpur, Maharashtra, India
Neha Awachar Department of Surgery, IGGMC, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20183721

Keywords:

Blunt trauma abdomen, Hemodynamically stable, Non-operative management

Abstract

Background: The present study of role of non-operative management in blunt abdominal trauma with solid organ injury was done to assess the feasibility and safety of non-operative management in hemodynamically stable patients and identify the causes, predictive factors to delineate the rate of non-operative management failure.

Methods: A longitudinal observational study was carried out from September 2013 to November 2015. All cases of blunt trauma abdomen with ultrasonological e/o solid organ injury and were hemodynamically stable were included in study.

Results: Total 138 cases presented with a history of blunt trauma abdomen of which 56 cases had ultrasonological evidence of solid organ injury. 8 cases were excluded as 6 of these were hemodynamically unstable at presentation while 1 had bowel perforation and another had severe head injury all requiring operative management. Maximum cases were of age group 21-30 years (41.66%) and 31-40 years (31.25%). 42 (87.5%) cases were male and 6 (12.5%) cases of 48 were females. 28 (66.67%) cases presented as Road Traffic Accident. 28 (66.67%) cases had abdominal pain as the commonest symptom while tenderness in 38 (79.17%) cases and tachycardia in 30 (75%) cases was the predominant sign. Most injuries were seen in spleen 23 (47.92%) cases f/b Liver with 14 (29.12%). Conservative management was successful in 40 (83.33%) cases and failed in 8 (16.67%) cases. Mortality of the study was 1 (2.08%) case.

Conclusions: Non-operative strategy is a successful approach in patients who are hemodynamically stable and authors strongly recommend it.

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