Abstract
Blunt injury trauma is regularly encountered in the emergency department. Diagnostic tools that help in optimum management of blunt abdominal trauma include; Focussed Assessment Sonography for Trauma scan, Diagnostic peritoneal lavage and Computed Tomography scan. The aim of this study is to determine the validity of CT scan as an accurate diagnostic tool and its role in management of patients with blunt abdominal trauma. A prospective analysis of 80 patients of blunt abdomen trauma who were admitted in Manipal Teaching Hospital, Pokhara, Nepal within a span of 15 months was done. Demographic data, mechanism of trauma, management and outcomes were studied. Organ injuries were graded using the Organ Injury Scale guidelines. Most of the patients in our study were in the age group of 21-40 years with an M: F ratio of 2.3:1. Road traffic accident (47.5%) was the most common mechanism of injury. Spleen (27.5%) was the commonest organ injured. CT scan was superior to FAST scan and had sensitivity of 97.3% specificity 75% positive predictive value 98.6%. FAST scan had sensitivity of 78.9%, specificity 50%, positive predictive value 96% with p- value of 0.0034. 81% of patients were conservatively managed. In conjunction with close clinical monitoring, CT scan is reliable in the evaluation and management of blunt abdominal trauma patients. Our study also shows CT as a superior diagnostic modality compared to FAST scan.
Highlights
Blunt injury trauma is regularly encountered in the emergency department
Major change in the paradigm of the management of blunt abdominal trauma is the introduction of nonoperative management coinciding with the availability of Computed Tomograpy (CT) scans, the role of imaging becomes even more paramount for the safe practice of such surgical restraint.[5,6]
CT scan of abdomen and pelvis was done in patients with clinical suspicion of intra-abdominal injury, polytrauma patients and with a positive ultrasonography study
Summary
Blunt injury trauma is regularly encountered in the emergency department. Diagnostic tools that help in optimum management of blunt abdominal trauma include; Focussed Assessment Sonography for Trauma scan, Diagnostic peritoneal lavage and Computed Tomography scan. The aim of this study is to determine the validity of CT scan as an accurate diagnostic tool and its role in management of patients with blunt abdominal trauma. CT scans, unlike direct peritoneal lavage (DPL) or Focused Assessment with Sonography for Trauma (FAST), have the capability to determine the source of Major change in the paradigm of the management of blunt abdominal trauma is the introduction of nonoperative management coinciding with the availability of Computed Tomograpy (CT) scans, the role of imaging becomes even more paramount for the safe practice of such surgical restraint.[5,6]
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