ANALYSIS OF INJURY PATTERNS AND OUTCOMES OF PATIENTS WITH BLUNT ABDOMINAL TRAUMA – A TERTIARY CARE CENTRE EXPERIENCE

Abstract

OBJECTIVE:Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups. Hemodynamic status of the patients and abdominal imaging play a major role in deciding the mode of management. The aim of this study is to analyse the clinical presentations, management and factors predicting outcome in patients with blunt injury abdomen presenting to a tertiary care centre in South India. METHODS:Combined retrospective and prospective analysis of prospectively maintained institutional database was performed. Data of all patients admitted with blunt abdominal trauma was analysed with regards to baseline characteristics, management and outcomes. RESULTS: One hundred and ten patients were admitted with blunt abdominal trauma in our institution from July 2014 to June 2015. Ninety-eight patients (89.1%) were male. The most common mode of injury was road trafc accidents (75.5%). Most common organs injured were spleen (28.2%), liver (22.7%) and small bowel (18.2%). Majority of the patients (73.6%) underwent operative management. Success rate of non-operative management was 89.7%. Overall mortality rate was 20.9%. CONCLUSION: Blunt abdominal trauma is associated with signicant morbidity and mortality. Computed tomography is the imaging modality of choice in hemodynamically stable patients to decide management. Non-operative management is successful in carefully selected cases. Old age, delayed presentation, presence of peritonitis, hemodynamic instability, and need for postoperative mechanical ventilation are associated with increased mortality.