A prospective evaluation of blunt trauma abdomen in rural setup

Abstract

Introduction: Blunt abdominal trauma accounts for the majority of abdominal injuries seen in the Emergency Department. It is responsible for substantial morbidity and mortality. Selecting appropriate approach has been recently a point of conflict in management of abdominal blunt trauma, and criteria for non- operative management are being changed frequently. Objective: With aim to identify some of the determining factors of successful non-operative management. Methods: A 2 year tertiary care teaching hospital based longitudinal study was done. Selection criteria were defined and a prestructured proforma was made to assess and note the findings. Results: 34 patients were studied. 29.4% of patients were in the age group of >20-30 years with the mean age 35.29 ± 15.84 years. 79.4% were male. Road traffic accident was responsible for 79.4% of blunt abdominal trauma cases while majority of the patients presented with abdominal pain (91.2%) and abdominal tenderness (91.2%). Associated extra abdominal injuries were found in 10 cases. The common extra abdominal injuries were head injuries (14.7%). 9 patients underwent exploratory laparotomy. 25 were selected for non-operative management. The most commonly injured organ was spleen (38.9%) followed by liver & stomach. 3 patients died in the present study. The sensitivity and specificity of the Emergency USG findings were 80.9% and 92.3% respectively, and that of the CT findings were 100% and 0% respectively. Conclusion: Non operative management (NOM) was found to be highly successful and safe. Hemodynamic stability along with ultra sound, CT scan and repeated clinical examination were the sheet anchors of NOM