Solid Organs Injuries in Blunt Abdominal Trauma Patients

Abstract

Background: Trauma is a major public health problem worldwide, morbidity and mortality in solid organ injuries (SOIs) following blunt abdominal trauma are often related to the severity of associated injuries. The management of SOIs depends upon the hemodynamic status of the patients. Hemodynamically unstable patients often require surgical management. Nonoperative management (NOM) is preferred in hemodynamically stable patients. Objective: This study was conducted to detect both incidence of solid organs injuries in blunt abdominal trauma patients and pattern of injuries as well as outcome in operative management comparing to non-operative management patients. Patients and methods: During the study period, total number of 6908 polytrauma patients presented to Mansoura University Emergency Hospital. Among them 685 (9.9%) presented by abdominal trauma. There were 173 cases with penetrating abdominal trauma and 512 cases with blunt abdominal trauma (BTA). Among the cases with BAT, 268 cases were excluded and the remaining 244 were included in the current study. Results: The most common cause of trauma was road traffic accidents (RTA) (64.3%) of the cases. Solid organs were affected in (70.1%) of the cases, bowels and other abdominal organs were affected in (24.2%), combined solid organs and other abdominal injuries were detected in (5.7%) of the cases. Spleen was the most affected organ in 55.1% of the cases. Total operative management (OM) was required in 70 cases (37.8%) and total NOM was required in 115 cases (62.2%). The overall incidence of mortality was 5.4%. There was no statistically significant difference in the length of hospital stay between the cases according to management (operative or non-operative). Conclusion: Hemodynamically stable blunt abdominal trauma with solid organ injury may be managed safely using a NOM approach.