PATTERNS AND OUTCOME OF PENETRATING ABDOMINAL TRAUMA.

Abstract

Objectives: To determine the mode of penetrating injuries to abdomen and to determine the effect of these injuries on outcome and to formulate recommendations for management of patients sustaining penetrating abdominal trauma. Study Design: Descriptive, cross sectional. Setting: Surgical Department Sandeman Provincial hospital, Quetta. Period: 1 year 2012-2013. Methodology: 147 consecutive cases of abdominal trauma presenting to emergency were studied for pattern of injury and management outcome. Data was recorded and analyzed using SPSS v10. Frequency tables were generated for various variables. Results: The commonest mode of injury was stabbing occurring in 76 cases (51.7%) followed by gunshot injuries in 60 cases (40.8%), 11 patients (7.4%) sustained blast pellet injuries. Patients were either managed conservatively or underwent laparotomy depending on mechanism of injury and clinical presentation. Stab and blast pallet wounds which were superficial were managed by local wound exploration those with peritoneal breach, hemodynamic instability and visceral evisceration were managed by Laprotomy. All gunshot injuries underwent mandatory Laprotomy. Gut was most commonly injured viscus followed by liver and kidney. Types of procedure performed were primary repair, bowel resection, protective ileostomy, splenectomy, nephrectomy, 2 patients were managed by damage control i.e. liver packing. Overall mortality was 5%. Conclusion: Mandatory laprotomy for all gunshots, and stabs and pellets that penetrate the peritoneal cavity proves to be safe and a prudent policy.