Liver and Spleen Injuries and Associated Rib Fractures: An Autopsy Study

Nuwadatta Subedi

doi:10.4172/2157-7145.1000240

Abstract

Extra thoracic injuries in rib fractures often include intra-abdominal organ injuries, commonly liver and spleen. The study was conducted with an objective to determine the association between rib fractures and liver and spleen injuries among medico legal autopsies with blunt abdominal trauma at the mortuary of tertiary referral centre in eastern Nepal for the period of one year. Among a total of 68 cases studied, male: female ratio was 3.53:1 and the mean age 30.76 ± 5.14 years. The presence of liver injuries was significantly increased in all rib fractures (P value 0.378, OR 1.552) and right sided only or bilateral ribs fractures (P value <0.05, OR 0.33). Spleen injuries are significantly associated with left sided only or bilateral rib fractures (P value <0.05, OR 3.02). A significant difference exists between organ injuries with associated rib fractures compared to those without fracture, implying that the presence of rib fracture is a good indicator of organ injury

Highlights

The abdominal cavity extends superiorly into the osseocartilaginous thoracic cage to the fourth intercostal space
Association of liver and spleen injuries with rib fractures was investigated in blunt trauma cases
The results of our analysis shows the patterns of liver and spleen injuries in relation to the presence or absence of overlying rib fractures

Summary

Introduction

The abdominal cavity extends superiorly into the osseocartilaginous thoracic cage to the fourth intercostal space. The more superiorly placed abdominal organs (spleen, liver, part of the kidneys, and stomach) are protected by the thoracic cage [1]. Its fixed position and friable consistency, the liver is frequently wounded by a stab in the abdomen, is often ruptured by a blunt trauma. It may be lacerated by the fractured ends of the ribs perforating the diaphragm. The spleen may sometimes be ruptured by the broken ends of a rib which may be caused by the blunt trauma [3]

Results

Discussion

Conclusion