A CLINICAL STUDY OF PENETRATING ABDOMINAL TRAUMA WITH SPECIAL REFERENCE TO ITS MANAGEMENT : AN INDIAN SCENARIO

Abstract

Introduction: The incidence of penetrating abdominal injuries has been on the rise. The common availability of rearms, the lack of proper law, armed conicts, civil violence and road trafc accidents are the major causes of penetrating abdominal injuries. As patient with penetrating abdominal trauma are at risk of harbouring life threatening injuries, early diagnosis and timely intervention is the most important steps to reduce its morbidity as well as mortality. Recently due to improvement of the present healthcare system, the outcome of these injuries is improving. Materials And Methods: A descriptive observational study was carried out on 60 cases of penetrating abdominal injuries. A predesigned pretested schedule was used for data collection. Interview of the study subject and evaluation of all clinical reports was done to obtain the history, clinical ndings, management, complications, mortality and follow up. Before data collection, informed consent was obtained from each and every study subjects. Results: The overall incidence of penetrating abdominal trauma was found to be 2.30% of the total admission of 6217 patients in the department of surgery. The most common cause of penetrating abdominal injury found in this study is stab injury by sharp objects which is followed by gunshot injury. The commonest age group affected was 20 to 30 years which comprises about 41.67%. In this study we found a male preponderance in cases of penetrating injury to the abdomen. In most of the cases the mode is homicidal stab or gunshot injury followed by accidental injuries. Pain, abdominal distension and bleeding from the wound are the main presenting symptom. After initial evaluation with USG (FAST),CTscan abdomen is the most valuable investigation so far. In this series, it is found that the small intestine is the most commonly involved viscera followed by colon, omentum, mesentery and liver respectively. Most common complications after operative intervention was wound infection. The average hospital stay was 6 to 15 days. It has been observed that the post-operative complications, associated injuries and multiple organ injuries are the cause of increased hospital stay. Conclusion: Penetrating trauma can be serious because it can damage internal organs and presents a risk of shock and infection. In the present year, due to overall improvement in the communication and transportation, better monitoring systems and resuscitative measures, improvised diagnostic methods, better availability of blood and blood products, better medications and more skilful surgical techniques, the outcomes of these injuries are improving.