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A study of blunt and penetrating abdominal trauma, its various patterns of injuries, and its management

Pallav Patel, Jaydeep Gadhavi, Hiren Parmar.




Abstract

Background: Abdominal trauma is one of the most common injuries among injuries caused mainly due to road traffic accidents. The rapid increase in motor vehicles and its aftermath has caused rapid increase in the number of victims to blunt abdominal trauma (BAT). Motor vehicle accidents account for 75%–80% of BAT. The knowledge in the management of BAT is progressively increasing due to the inpatient data gathered from different parts of the world. In spite of the best techniques and advances in diagnostic and supportive care, the morbidity and mortality remains at large. The reason of this could be due to the interval between trauma and hospitalization, delay in diagnosis, inadequate or lack of appropriate surgical treatment, postoperative complications, and associated trauma especially to spine, head, thorax, and extremities.

Objective: To study the blunt and penetrating abdominal trauma, its various patterns of injuries, and its management.

Materials and Methods: After initial resuscitation of the trauma victims, a careful history was taken to document any associated medical problem. Documentation of patients, which included identification, history, clinical findings, diagnostic test, operative findings, operative procedures, and complications during the stay in the hospital and during subsequent follow-up period, was recorded on a Performa specially prepared. The decision for operative or nonoperative management depended on the outcome of the clinical examination and results of diagnostic tests. Patients selected for nonoperative or conservative management were placed on strict bed rest and subjected to serial clinical examinations that included hourly pulse rate, blood pressure, respiratory rate, and repeated examination of abdomen and other systems.

Result: The most common age group involved in BAT was between 13 and 20 years, whereas in penetrating abdominal trauma was between 21 and 30 years. This study showed that of 100 cases of abdominal trauma, 19 were presented with shock (blood pressure

Key words: Blunt abdominal trauma, penetrating abdominal trauma, conservative management, surgical management






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