Prognosis of abdominal injuries in trauma patients in two university hospital unit of Lubumbashi

Abstract

Introduction: Abdominal trauma is a major public health concern. The purpose of our study was to determine the frequency, the etiologies and to assess the management as well as the evolution of abdominal trauma in Lubumbashi.Patients and Methods: This was a cross-sectional descriptive study carried out in surgical emergency department of two university hospital units, the University Clinics of Lubumbashi and the Janson SENDWE Provincial Referral Hospital over a period from January 2018 to December 2021. We reviewed prospectively medical records of patients who had laparotomy or not after abdominal trauma. It had involved 93 patients with abdominal trauma. Statistical analyzes were performed using Epi info 7.2.2.6 software and IBM SPSS 25 software.Results: We collected 93 files. The frequency of severe abdominal trauma managed in our department was 3.89%. Etiologies were dominated by road traffic accidents (62.37%).There was a male predominance (83.87%) and the average age was 28.77±13.84 with extreme ages 1 and 68 years old. The median admission time was 2hours; many patients arrived at the hospital within an hour (41.94%) and 52.68% of patients were hemodynamically unstable. Fifty two point seventy five percent of surgeries lasted between one to two hours. Abdominal contusions have represented 66.37% of cases and abdominal wounds 34.63% of cases. Indications for surgery were hemodynamic instability, evidence of lesion of a hollow viscus, the presence of evisceration or a gunshot wound, and initial non-operative treatment failure. The organ most affected in abdominal trauma remains the spleen in thirty-two patients (34.40% of cases), followed by the liver in twenty-four patients (25.80% of cases). Forty four point eight percent of patients had a hospital a hospital stay between 8 and 14 days with an average hospital stay of 10.87±6.27 days. Postoperative morbidity was 34.41% dominated by intra-abdominal re-bleeding in 9.67% and overall mortality was 23.66%. Conclusion: Abdominal trauma remains one of important activities of general surgeons in our country. Its morbidity and mortality remains fairly high in our precarious environments and surgical management is still relevant, especially indicated for hemodynamic instability and perforation of hollow organs.