Blunt abdominal trauma: the experience in rural India and review of literature

Authors

  • Mohd Hamid Shafique Ahmed Department of Urology, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India
  • Lalit Vishwanath Tamgadge Department of General Surgery, Government Medical College, Chandrapur, Maharashtra, India
  • Prakash D. Gurav Department of General Surgery, Government Medical College, Miraj, Maharashtra, India
  • Santosh B. Dalavi Department of General Surgery, Government Medical College, Miraj, Maharashtra, India
  • Sanket Bankar Department of General Surgery, Government Medical College, Miraj, Maharashtra, India
  • Ritesh Parmar Department of General Surgery, Government Medical College, Miraj, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20195930

Keywords:

Blunt abdominal trauma, Hemoperitoneum, Road traffic accident

Abstract

Background: Blunt Abdominal trauma is one of the most common injuries caused due to road traffic accidents. The rapid increase in number of motor vehicles and its aftermath has caused rapid increase in number of victims due to blunt abdominal trauma. As the care of patients with blunt abdominal injuries is largely a surgical responsibility and abdominal injuries involving major hemorrhage from solid viscera constitute surgical emergencies. Abdominal blunt traumas represent a real diagnostic and therapeutic challenge to even a most experienced surgeon, thereby representing importance of its study. Early diagnosis and effective management help in decreasing mortality in blunt abdominal trauma.

Methods: Prospective study of 50 patients admitted to the institute with history of Blunt Abdominal Trauma. After initial resuscitation of the patients, thorough assessments for injuries were carried out in all the patients. Documentation of patients, which included identification, history, clinical findings, diagnostic test, operative findings, operative procedures and complications during the stay in the hospital were all recorded on a Performa specially prepared. The management was decided depending upon history, clinical examination and investigations.

Results: Males were predominantly affected, and most cases were between the age group of 21-40 years (76%). Majority of the patients (90%) presented with the complaint of abdominal pain followed by abdominal distension (56%). 36(60%) patients were managed conservatively while operative interventions were required in 24(40%) patients. The common surgeries performed in the patients included splenectomy, primary closure of perforation and resection and anastomosis of bowel. Majority of the patients (80%) were discharged within 20 days of admission. The mortality in present study was 13.3%.

Conclusions: Blunt Abdominal Trauma is one of the important causes of morbidity and mortality in young adults. Immediate resuscitative measures, management of associated injuries and appropriate operative intervention are important parts of management of such cases.

References

Cusheri A, Giles R, Moosa A. R: Essential Surgical Practice; Butterworth Inter Ed. 1998:263-304.

Martin RS, Meredith JW. Management of acute trauma. In: Townsed CM, Beachamp RD, Evers BM, Mattox KL, editors. Sebiston Textbook of Surgery:The biological basis of modern surgical practice. 19th ed. Canada; Elsevier Saunders: 2012:430-469.

Davis JJ, Cohn Jr IS, Nance FC. Diagnosis and management of blunt abdominal trauma. Annal Surg. 1976 Jun;183(6):672-8.

Anjum Fazili MS, Shabana Nazir MB. Clinical profile and operative management of Blunt Abdominal Trauma (Bat): a retrospective one-year experience at SMHS hospital, Kashmir, India. JK Practitioner. 2001;8:219-21.

Fleming S, Bird R, Ratnasingham K, Sarker SJ, Walsh M, Patel B. Accuracy of FAST scan in blunt abdominal trauma in a major London trauma centre. Int J Surg. 2012;10(9):470-4.

Hamidi MI, Aldaoud KM, Qtaish I. The role of computed tomography in blunt abdominal trauma. Sultan Qaboos Univer Med J. 2007 Apr;7(1):41-6.

Nance ML, Peden GW, Shapiro MB, Kauder DR, Rotondo MF, Schwab CW. Solid viscus injury predicts major hollow viscus injury in blunt abdominal trauma. J Trauma Acute Care Surg. 1997 Oct 1;43(4):618-23.

Wu CL, Chou MC. Surgical management of blunt abdominal trauma. Gaoxiong Yi Xue Ke Xue Za Zhi. 1993;9:540-52.

Di Vincenti FC, Rives JD, Laborde EJ, Fleming ID, Cohn I Jr. Blunt abdominal trauma. J Trauma. 1968 Nov;8(6):1004-13.

Cox EF. Blunt abdominal trauma. A 5-year analysis of 870 patients requiring celiotomy. Annals Surg. 1984 Apr;199(4):467-74.

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Published

2019-12-25

How to Cite

Ahmed, M. H. S., Tamgadge, L. V., Gurav, P. D., Dalavi, S. B., Bankar, S., & Parmar, R. (2019). Blunt abdominal trauma: the experience in rural India and review of literature. International Journal of Research in Medical Sciences, 8(1), 322–326. https://doi.org/10.18203/2320-6012.ijrms20195930

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Original Research Articles