DOI: http://dx.doi.org/10.18203/2349-2902.isj20203256

A retrospective study of blunt trauma abdomen in a tertiary center in central India: evaluation, management and outcome

Sanjay Sisodiya, Prateek Malpani

Abstract


Background: Blunt abdominal trauma is fairly common emergency and it is one of the important components of polytrauma. It requires high degree of suspicion, investigation and management. Inspite of improved imaging techniques leading to early recognition it is still associated with high morbidity and mortality. Trauma is the leading cause of blunt abdominal injury. This aim of the study was to find etiology, early diagnosis and management of patients with blunt abdominal trauma.

Methods: This a retrospective study conducted in Gandhi medical college, Bhopal in which 90 cases of blunt abdominal trauma presented to emergency and outpatient department were included in the study duration of January 2019 to December 2019.

Results: Motor vehicle accident was the most common mode of injury. Liver being the most common visceral organ injured while the most common surgery performed was the repair or resection and anastomosis of hollow viscous perforation. Rib fracture was the most common extra abdominal injury seen in 17.7% cases. Mortality rate was 5.5%. Most of the liver, spleen and renal injuries can be managed non-operatively whereas hollow viscous injury needs laparotomy.

Conclusions: The result of present study is similar to other studies. Rapid diagnosis, early and timely referral, adequate and trained staff, close and careful monitoring, early wise and skilled decision to go for operative or non-operative management can help save many lives.


Keywords


Blunt abdominal trauma, Motor vehicle accident, Nonoperatively

Full Text:

PDF

References


Vlies CH, Olthof DC, Gaakeer M. Changing patterns in diagnostic strategies and the treatment of blunt injury to solid abdominal organs. Int J Emerg Med. 2011;4:47.

Ahmet K, Tongue Y. Blunt abdominal trauma: evaluation of diagnostic options and surgical outcomes. Turkish J Trauma Emerg Surg. 2008;14:205-10.

Muller L, Benezet JF, Navarro F, Eledjam JJ, Coussaye JE. Serious blunt abdominal trauma: Diagnostic and therapeutic strategy. Encycl Méd Chir Anesth Réanim. 2003;22:12.

Fernandes MT, Dorigatti EA, Monteiro BT. Nonoperative management splenic injury grade IV is safe using rigid protocol. Rev Col Bras Cir. 2013;40:323-8.

Hassan R, Aziz AA. Computerized tomography (CT) imaging of injuries of blunt abdominal trauma: a pictorial assay. Malays J Med Sci. 2010;17:29-39.

Taviloglu K, Yanar H. Current trends in the management of blunt solid organ injuries. Eur J Trauma Emerg Surg. 2009;35:90-4.

Davis J, Cohn I, Nance F. Diagnosis and management of blunt abdominal trauma. Ann Surg. 1996;183:880-6.

Morton J, Hinshaw R. Blunt trauma to the abdomen. Ann Surg. 1957;145:699-711.

Fazili A, Nazir S. Clinical profile and operative management of blunt abdominal trauma: a retrospective one year experience at SMHS hospital, Kashmir, India. JK Practit. 2001;8:219-21.

Nikhil M, Sudarshan B, Kumar V. An experience with blunt abdominal trauma: evaluation, management and outcome. Clin Practice. 2014;4:59.

Kala SK, Mathur RK, Singh SP. A clinical study of blunt trauma abdomen. Int J Recent Trends Sci Technol. 2015;15(3):626-30.

Aziz A, Bota R, Ahmed M. Frequency and pattern of intra- abdominal injuries in patients with blunt abdominal trauma. J Trauma Treat. 2014;3:196.

Ammar SA, Hassani A, Menyar AE, Patient demographic basic data. J Emerg Trauma Shock. 2015;8(4):193-8.

Gholipour S, Roozbahany MM, Baharvand P. Spectrum and outcome of blunt trauma abdomen at Sardar Patel Medical College and PBM and Associate Group of Hospitals. Int J Review Life Sci. 2014;4(9):31-7.

Shackford SR. The evolution of modern trauma care. Surg Clin North Am. 1995;75:147-56.

Khichi Z, Afridi HK, Mateen A, Kehiri GQ. Audit of thoraco-abdominal injuries in road traffic accidents in Larkana Autopsy study. Pak J Med Health Sci. 2013;7(4):1109-12.

Singh M, Kumar A, Verma AK, Kumar S, Singh AK. Abdominal organ involvement in blunt injuries. J Indian Acad Forensic Med. 2012;34(1):24-6.

Devis JJ, Cohn I, Nance FC. Diagnosis and management of blunt abdominal trauma. Am Surg. 199:467;1976.

Sule AZ, Kidmas AT, Awani K, Uba F, Misauno M. Gastrointestinal perforation following blunt abdominal trauma. East Afr Med J. 2007;84:429-33.

Tripathi MD, Srivastava RD. Blunt abdominal trauma with special reference to early detection of visceral injuries. Int J Surg. 1991;53(5):179-84.

Jolley S, Upadhyay M, Jain RL. Blunt abdominal trauma a clinical study of 100 cases. Int J Sur. 1993;9:3.

Perry JF, McCleelan RJ. Autopsy findings in 127 patients following fatal traffic accidents. Surg Gynaec Obstet. 1964;119:586-90.

Mohan D. Injuries in India, a Survey. ICSSR research abstract. IIT Bulletin, IIT Delhi. 1992:8-10.

Hanmantha A, Reddy BN, Pallvi M, Reddy NN, Radhakriashna L, Narasimha S. An epidemiological study on pattern of thoracoabdominal injuries sustatined in fatal road traffic accidents of Banglore. Autopsy basded study. Narayana Med J. 2012;2:19-21.

Hughes TM, Elton C. The pathophysiology and management of bowel and mesenteric injuries due to blunt trauma injury. 2002;33(4):295-302.

Mahapatra S, Pattanayak SP, Rao KRRM, Bastia B. Options in the management of solid visceral injuries from Blunt abdominal trauma. Indian J Surg. 2003;65:263-8.

Rozycki GS, Ochsner MG, Schmidt JA, Frankel HL, Davis TP. A prospective study of surgeon performed ultrasound as the primary adjuvant modality for injured patient assessment. J Trauma. 1995;39(3):492-8.

Velmahos GC, Toutouzas KG, Radian R, Chan L, Demetriades D. Non operative treatment of blunt injury to solid abdominal organs: a prospective study. Arch Surg. 2003;138(8):844-51.

Nain PS, Singh K, Matta H. Review of 9 cases of diaphragmatic injury following blunt trauma chest; 3 years’ experience. Indian J Surg. 2014;76(4):261-4.

Gul SI, Rahid A, Wani I. Countre–coupe injury of the gut”; isolated traumatic mesenteric border jejunal perforation. J Case Rep Practice. 2014;2(1):23-5.

Beall AC, Bricker DL, Alessi FJ. Surgical considerations in the management of civilian colon injuries. Ann Surg. 1970;173:971-8.