A study to assess the 30 days outcome of penetrating injuries to the abdomen


  • Neeraja Tillu Department of General Surgery, Lokmanya Tilak Medical College, Sion, Mumbai, Maharashtra, India
  • Chetan Rathod Department of General Surgery, Lokmanya Tilak Medical College, Sion, Mumbai, Maharashtra, India
  • Meena Kumar Department of General Surgery, Lokmanya Tilak Medical College, Sion, Mumbai, Maharashtra, India
  • Vinit Kumar Department of General Surgery, Lokmanya Tilak Medical College, Sion, Mumbai, Maharashtra, India




Abdominal trauma, Conservative management, Exploratory laparotomy, Morbidity score


Background:Abdominal trauma is among the leading causes of morbidity and mortality in all age groups in the world. Many injuries may not manifest during the initial assessment and treatment period. The study was conducted to determine the different characteristics of the patients with abdominal trauma, to analyse the extent of organ involvement and to determine the surgical interventions done for the same and to understand the morbidity caused by various operative procedures, especially due to negative laparotomy.

Methods: A descriptive, prospective, hospital-based study involving observation of patients from admission to final outcome of management at discharge or death was carried out. Consecutive admissions of 54 patients with abdominal injuries attended to at the department of surgery, Lokmanya Tilak Medical College, Sion, Mumbai were enrolled in the study. The study was conducted from September 2013 to September 2015. The data were analyzed using SPSS software.

Results:54 patients were enrolled in the study. Male to female ratio was 5.75:1. Mean age was 29.31 years. Majority of the patients (83.33%) were affected with homicidal stab wounds. The object causing penetrating injury was most commonly a knife, which was used in 44 patients (81.5%). Thirty patients (55.55%) had isolated penetrating injuries to the abdomen whereas 24 patients (44.45%) had associated injuries. Amongst the stab wounds, the commonest site of injury was the umbilical region. The average systolic BP was measured in all the patients. The mean revised trauma score of all patients was 7.66. The contingency values of patients undergoing chest X-ray, FAST, CT scan and peritoneal breach v/s patients undergoing exploratory laparotomy were noted. Primary closure of jejunal perforation (12.5%) and gastric perforation (12.5%) were the most common operative procedures done. Jejunum was the most frequently damaged organ in most of the patients. The average penetrating abdominal trauma index of the patients was 6.77. The operative time, time spent on ventilator, days stayed in ICU, length of hospital stay, time taken by the patients to walk , to sip and to remove mid line suture were noted.

Conclusions:Increased efforts to repair early are likely to reduce the incidence and mortality in patients with abdominal trauma. Selective non operative management can be practiced in tertiary care centers but its benefits must be weighed against the risk of missed injuries.


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