Hollow viscus injury due to blunt abdominal trauma

Surya Ramachandra Varma Gunturi; Venu Madhav Thumma; Jagan Mohan Reddy Bathalapalli; Nava Kishore Kunduru; Kamal Kishore Bishnoi; Nirjhar Raj Rakesh; Gangadhar Gondu; Digvijoy Sarma; Bheerappa Nagari

doi:10.18203/2349-2902.isj20170429

Authors

Surya Ramachandra Varma Gunturi Department of Surgical Gastroenterology, Nizam’s institute of Medical Sciences, Hyderabad, India
Venu Madhav Thumma Department of Surgical Gastroenterology, Nizam’s institute of Medical Sciences, Hyderabad, India
Jagan Mohan Reddy Bathalapalli Department of Surgical Gastroenterology, Nizam’s institute of Medical Sciences, Hyderabad, India
Nava Kishore Kunduru Department of Surgical Gastroenterology, Nizam’s institute of Medical Sciences, Hyderabad, India
Kamal Kishore Bishnoi Department of Surgical Gastroenterology, Nizam’s institute of Medical Sciences, Hyderabad, India
Nirjhar Raj Rakesh Department of Surgical Gastroenterology, Nizam’s institute of Medical Sciences, Hyderabad, India
Gangadhar Gondu Department of Surgical Gastroenterology, Nizam’s institute of Medical Sciences, Hyderabad, India
Digvijoy Sarma Department of Surgical Gastroenterology, Nizam’s institute of Medical Sciences, Hyderabad, India
Bheerappa Nagari Department of Surgical Gastroenterology, Nizam’s institute of Medical Sciences, Hyderabad, India

DOI:

https://doi.org/10.18203/2349-2902.isj20170429

Keywords:

Blunt abdominal trauma, Hollow viscus injury, Poly trauma

Abstract

Background: Management of hollow viscus injury (HVI) due to blunt abdominal trauma (BAT) is a challenge to the clinicians even in the era of advanced imaging and enhanced critical care. Repeated clinical examination with appropriate imaging with multidisciplinary teamwork is the key for timely intervention in equivocal cases for successful outcomes. Aim of the study was to present our experience over last 4½ years.

Methods: This is a retrospective study of prospectively collected data of patients treated at surgical gastroenterology department, Nizam’s Institute of Medical Sciences, Hyderabad, India over a period of 4½ years (2012-2016).

Results: A total of 126 BAT Patients were treated in our unit as inpatients during the last 4½ years. Out of 126, twenty patients (15.87%) with HVI in whom surgical intervention was done formed the study group. Contrast enhanced CT Scan abdomen and chest was done in stable patients (13/20), in rest of the patients (7/20) the decision to operate was taken more on clinical grounds along with X-ray abdomen and USG abdomen features. 12 (60%) had jejunal and ileal injuries, 5 (25%) patients had colonic injuries (sigmoid 4, caecum 1). One (5%) patient had extra peritoneal rectal perforation with ascending retroperitoneal fascitis and 2 (10%) had duodenal injury. Two (10%)patients required relaparotomy. We had mortality in 3 (15%) patients and 17 (85%) patients had complete recovery.

Conclusions: Hollow viscus injury should be suspected in all cases of blunt abdominal trauma. In equivocal cases careful repeat clinical examinations with close monitoring and repeat imaging is highly essential to prevent delay in intervention. Type of procedure is based on time of presentation, degree of contamination, associated injuries and general condition of the patient.

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Author Biography

Surya Ramachandra Varma Gunturi, Department of Surgical Gastroenterology, Nizam’s institute of Medical Sciences, Hyderabad, India

Assistant Professor

Department of surgicalgastroenterology

Nizam's Institute of Medical Sciences

Panjagutta

Hyderabad

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