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Original Research

RMJ. 2014; 39(1): 68-71


Penetrating abdominal injury: A tertiary care hospital experience

Anis Uz Zaman, Muhammad Iqbal, Farhan Zaheer, Rehan Abbas Khan, Khalid Ahsan Malik.

Abstract
Objective: Purpose of our study is to describe the pattern of visceral injuries in penetrating trauma patients, their association with entry wounds and to observe the outcome of patients after surgical intervention. Patients and Method: This study included 79 patients with abdominal trauma who presented in the Accident and Emergency department of Civil hospital Karachi and underwent exploratory laparotomy from October 2011 to April 2013. A proforma was used to document patientís demography, findings and final outcome. Results: Most patients were in the age group of 21 to 30 years (42.7%). 76 (96.2%) patients were male and 3 patients were female. Most entry wounds were found on ventral abdominal wall (57%), involving the left upper quadrant in majority (31.6%) of patients. Intra-abdominal injuries, included liver (n = 14, 17.7%), spleen (n = 12, 15.2%), kidney (n = 4, 5.1%), pancreas (n = 4, 5.1%), stomach (n = 12, 15.2%), small bowel (n = 34, 43%) and large bowel (n = 35, 44.3%). 41 patients have multiple organ injury. Associated injuries were present in 50.6% cases. Postoperative complication recorded were wound infection 30.4%, wound dehiscence 6.3%, abdominal sepsis 3.8% and mortality in 8 (10.1%) patients. Average hospital stay was 8 days. Conclusion: This study has highlighted that the pattern of visceral injuries can be predictable in fire arm trauma patients even before exploration. The entry wound, clinical stability and the surface area of visceral organs are the major determinants in predicting pattern of visceral involvement.

Key words: Penetrating trauma, abdominal injury, abdominal sepsis.






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