Cause Of Blunt Abdominal Trauma Research Articles

Pattern of Intra-Abdominal Injuries among Patients Presented with Blunt Abdominal Trauma

Background: Blunt abdominal trauma (BAT) represents a significant challenge in trauma care, particularly in developing countries where road traffic accidents (RTA) predominate as a cause. Understanding the demographic characteristics, etiology, and injury patterns associated with BAT is crucial for effective management and preventive strategies. Objective: This study aims to evaluate the patterns of BAT in patients presenting to Lady Reading Hospital, Peshawar, focusing on identifying the leading causes, affected demographic groups, and organ-specific injuries to inform better clinical practice and preventive measures. Methods: Conducted from January 1, 2023, to June 1, 2023, this cross-sectional study included 60 patients with BAT. Participants underwent comprehensive evaluations involving clinical assessments, radiological imaging, and laboratory tests, following Advanced Life Trauma Support guidelines. Data analysis utilized SPSS version 25, focusing on categorical and numerical variables to assess injury etiology, demographics, and organ involvement. Results: The majority of BAT patients were male (percentage provided in the full study), with a mean age of 35.42±11.31 years. RTAs were identified as the leading cause of BAT, contributing to (specific percentage) of cases. The liver (48.3%) and spleen (36.7%) were the most commonly injured organs. Other significant findings included injury rates for the intestine (13.3%), mesentery (10%), and kidney (5%). Conclusion: BAT predominantly affects younger males, with RTAs serving as the principal etiological factor. The high incidence of liver and spleen injuries necessitates prompt and precise diagnostic approaches. The study underscores the need for improved road safety measures and public health interventions to reduce BAT incidences, alongside enhancing emergency and trauma care capabilities.

Assessment of Frequency, Patterns, and Causes of Blunt Abdominal Trauma in a North Indian Cohort: An Autopsy-Based Study.

Introduction The abdomen is one of the most frequently damaged areas in trauma patients and is commonly encountered in road traffic accidents (RTAs). The present study evaluates the frequency, etiology, causation, and form of injuryin blunt abdominal trauma (BAT) cases who had autopsies. Method An autopsy-based observational prospective study was conducted at the Department of Forensic Medicine and Toxicology, Nalanda Medical College and Hospital Patna, India, during the period from October 2018 to September 2020, which included a total of 940 autopsy cases showing blunt abdominal injuries. A predesigned proforma for the postmortem evaluation of BAT victims was used to collect the required information on the cases. Descriptive statistics were performed, and the data were presented as frequency (%) and mean±SD. Chi-square tests were performed to compare categorical variables between groups. Results BAT accounted for 120 (12.76%) cases of all autopsies performed. The majority of victims were male(92.48%). Victims aged 21-30 years (31, 25.83%) were the ones most usually engaged in BAT cases. Among the mechanisms accountable for BAT, RTAs were the most common (99, 82.50%), followed by assault (16, 13.30%). In most of the cases, the liver was injured (107, 89.16%), followed by the spleen (60, 50.00%) and kidney (24, 20.00%). The majority of blunt abdominal injury-related deaths were accidental (100, 83.33%), followed by homicidal (15, 12.5%) and suicidal cases (5, 4.17%). Hemorrhage and neurogenic shock were the most prevalent causes of mortality, particularly if the individual died within a few hours. Conclusion RTAs are the most frequent cause of BAT in autopsy cases, and the liver is the most affected organ. The majority of deaths occur within the first 24 hours of injury. Since blunt abdominal injuries have the propensity to increase morbidity and mortality, appropriate emphasis on their precise diagnosis and satisfactory therapy is mandated.

Blunt abdominal trauma: initial resuscitation followed by clinical and focused abdominal sonography assessment important diagnostic tools of organ injury due to restricted use of CT-scan in a tertiary care in India

Background: Blunt abdominal trauma (BAT) is one of the common causes of admission in surgical ward in any hospital. It requires high level of suspicion, urgent evaluation and timely management to decrease morbidity and mortality. Objective was to evaluate the role of clinical and ultrasound assessment in early diagnosis of intra-abdominal injury following blunt abdominal trauma and follow up in patients with intraabdominal injury for detecting complications.Methods: 130 patients who presented to the emergency room were evaluated by clinical and focused abdominal sonography for trauma (FAST) and follow-up sonography was done after 6-12 hours upto 72 hours.Results: In our study, road traffic accidents (RTA) were the most common cause of blunt abdominal trauma (70.76%) with 75% patients being were males. X-ray erect abdomen and ultrasound of the abdomen were the most sensitive investigation for hollow viscous injury and solid organ injuries, respectively, with bowel (38.33%) and liver injury (26.67%) being the most common organ involved in this study. This study found sensitivity (93.7%) and specificity (98.5%) of focused abdominal ultrasonography (FAST).Conclusions: Initial resuscitation followed by clinical and ultrasonography assessment is considered the best modality in initial evaluation of blunt abdominal trauma patients as it is noninvasive, readily available, and requires minimal preparation time and also due to restricted use of modern amenities such as CT-scan in tertiary care in India.

Lessons learned from blunt trauma abdomen: Surgical experience in level I trauma centre.

The number of accident cases is increasing day by day, so as the challenges. With an emphasis on trauma care, the government started a 120 bedded level I trauma centre in northern India catering to a population of 2.8 million in June 2018. Through this article, we aimed to share our experience of blunt abdominal trauma management from a new level I trauma centre. In this retrospective observational study, historical analysis of all available records from July 2018 to March 2020 was done. Inclusion criteria included blunt trauma abdomen with or without associated injuries. Data regarding age, sex, mechanism of injury, time taken to reach the hospital, the pattern of solid organs and hollow viscus injuries, associated extra abdominal injuries, mode of treatment, complications, length of ICU and hospital stay, and mortality were reviewed. Overall, 154 cases sustained abdominal injuries during the study period. Seventy-five percent were male. The most common cause of blunt trauma abdomen was road traffic crashes. Operative management was required in 57 (37.01%) cases while 97(62.98%) were managed non-operatively (NOM). Mean ICU stay was 05.73 days, while the average hospital stay was 12 days (range 10-60 days). Procedures performed included splenectomy, liver repair, primary closure of bowel injury, and stoma formation. Complications occured in 16.88% cases and the overall mortality rate was 11.68%. The study revealed that among 154 cases of fatal blunt abdominal trauma, road traffic crash was the most common cause of blunt abdominal trauma, predominantly affecting males. The visceral and peritoneal injury frequently perceived was liver in 40 cases (25.9%), spleen 66 (43%), intestine 21(13.6%) and kidney 13 cases (09%). Abdominal injury was associated with other injuries like head, chest and extremity injuries in 52.5% cases. Duration of injury, presence of associated injury and preoperative ventilation requirement were independent predictors of mortality apart from contributary factors such as clinical presentation, organ involved and presence of complications.

Pattern of Fatal IntraAbdominal Injuries in Autopsy Cases- A 3 Year Retrospective Study

Introduction- Abdominal trauma is an injury to abdomen and is a common presentation in the emergencyroom if it is caused by blunt force. According to WHO, in few years trauma will become the first or secondleading cause of loss of productive years of life for both developed and developing countries. The mostcommon cause of blunt abdominal trauma are road traffic accidents, fall from height, assaults, industrialaccidents, etc.Objective- To study the pattern and prevalence of abdominal injuries in relation to the various epidemiologicalfactors.Materials and Methods- This retrospective study was conducted over a period of 3 years from January2016 to December 2018. The total number of cases studied were 120 showing abdominal injuries. Thisstudy on medicolegal autopsies was carried out at mortuary of Jawaharlal Nehru Medical College, Belagavi,Karnataka.Results- A total of 120 cases were included in this study who presented with blunt abdominal trauma. In ourstudy males (83 cases) outnumbered females (37 cases) and majority of the cases were in age group of 21-30years (38.3%). Most of the cases were from rural background (57.5%). Road traffic accidents (75.8%) werethe most common reason behind the abdominal trauma. The most common cause of death was shock andhaemorrhage (69.2%). Liver was involved in majority of the victims followed by spleen.

Trauma abdominal contuso por golpe con manubrio de bicicleta

Introducción: Los accidentes en bicicleta son una causa frecuente de trauma abdominal contuso en pediatría. En Chile no existen publicaciones científicas que traten sobre las lesiones abdominales por manubrio de bicicleta, su presentación y manejo.Objetivo: Describir tres casos clínicos de trauma abdominal contuso provocados por manubrio de bicicleta en niños, ilustrar las distintas lesiones observadas, sus formas de presentación y manejo.Casos Clínicos: 1) Paciente masculino, 11 años, consulta tras golpe con manubrio de bicicleta en epigastrio; en la Tomografía Computada (TC) de abdomen y pelvis se describió neumoretroperitoneo. Se realizó laparotomía exploradora, reparándose una perforación duodenal. 2) Paciente masculino, 14 años, consulta tras golpe en el hipocondrio izquierdo con el manubrio de la bicicleta; en la TC se evidenció fractura esplénica con múltiples laceraciones. Por la presencia de sangrado activo se trató con angioembolización, lográndose resolución de la lesión y viabilidad del órgano luego de 6 semanas de seguimiento. 3) Paciente masculino, 9 años, ingresó tras sufrir golpe con manubrio de bicicleta en el hipocondrio derecho. En TC se observó una laceración hepática, que fue manejada de forma expectante, con resolución de la lesión luego de 8 semanas de seguimiento. Todos los pacientes tuvieron una evolución favorable.Conclusión: El trauma abdominal contuso por golpe con manubrio de bicicleta puede ser potencialmente grave en pacientes pediátricos, pudiendo afectar órganos sólidos y vísceras huecas. El manejo no quirúrgico cada vez es más utilizado, logrando altas tasas de éxito en pacientes estables. Los pacientes inestables o en los que se sospeche perforación de víscera hueca, requerirán cirugía como primera aproximación.

Intra- Abdominal Injuries Following Blunt Abdominal Trauma-Analysis of 100 cases.

With the advent of industrialization, accelerated social violence, increasing road traffic accident and increasing use of machineries trauma has become the leading cause of mortality and disability. Considering trauma abdominal trauma is one where early diagnosis and accurate assessment and timely intervention can save the life of the victim in most of the instances. This is a prospective observational study that represents the experience of 100 consecutive patients of blunt abdominal trauma with suspected intra-abdominal injuries admitted in surgical words of RMCH, Rajshahi. The most of the patients were male (87%) and in active phase of life. RTA (53%) was the most common cause of blunt abdominal trauma and majority of the patients (38%) arrived in the hospital within 7-24 hours. Major clinical signs of intra-abdominal injuries were signs of peritonitis. The main investigation done was plain X-ray abdomen (71%) in erect posture, of which 55% cases showed free gas under the done of the diaphragm. Out of 100 cases 77 patients were operated upon and 23 patients were managed conservatively. The incidence of hollow viscus injury (57%) was higher than solid organs (36%) injury but only five patients came out to be a negative laparotomy. Of all operated cases fifty one were recovered uneventfully and only twenty three patients developed various postoperative complications. The most of the patients (40%) left the hospital within 11-14 days. Seven patients died on the day of admission but total mortality was nine (9%) in number.TAJ 2015; 28(2): 7-14

Comparative Study of Ultrasonography and Computed Tomography in the Evaluation of Blunt Abdominal Trauma at CMS-TH

Introduction: This study was conducted to compare the role of USG and CT as noninvasive imaging techniques for assessing the patient with blunt abdominal trauma.
 Methods: A prospective longitudinal study was performed at the College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan in the department of Radiodiagnosis, from January 2011 through July 2013. Where 150 patients following abdominal injuries were recorded, including patient age group, sex and mode of injury. Patient underwent USG and CT evaluation. The role of USG and CT was compared in the diagnosis of blunt abdominal trauma.
 Results: In our study, 80% of patient with blunt abdominal injury were male with the M:F ratio of 4:1. Road traffic accident was the most common cause of blunt abdominal trauma (72%). There were 95 (92.22%) patients positive for free fluid by USG and CT where 15 had no organ injury. CT revealed organ injuries in 88 (85.43%) patients whereas USG detected 72 (69.90%) organ injuries. Spleen 42 (47.72%) was the most common organ to be injured followed by liver29 (32.95%), kidney 7 (7.9%) and pancreas 3 (3.4%). 16 (18.18%) patients out of 88 positive for organ injuries were not associated with free fluid. Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of USG for organ injury were 81.81%, 100%, 100%, 79.48% and 89.3% respectively.
 Conclusions: USG and CT are useful noninvasive tools in detecting free intraperitoneal fluid and organ injuries in patients with blunt abdominal trauma. CT is superior to detect organ injuries in patients with blunt abdominal trauma.

Blunt abdominal trauma: a tertiary care experience

Background: Blunt abdominal trauma (BAT) is one of the common causes of admission in surgical ward in any hospital. It requires high level of suspicion, urgent evaluation and timely management to decrease morbidity and mortality. Aim of present study was to find out demographic details, causes of injury, management options and treatment outcomes of BAT.Methods: Retrospective study of cases of BAT was carried out at a tertiary care hospital of India spanning five years, between June 2012 to June 2017. Authors analyzed the demographic profile of the trauma victims, etiological factors of BAT, the abdominal organs involved, the treatment modalities adopted and the final outcome.Results: There were 231 cases of BAT. Most common age group was 11 to 30 years which accounted for 42.42% of the total. The study had 181 (78.35%) males and 50 (21.64%) females. Road traffic accident was the most common cause of BAT and it accounted for 67.97%. Liver (34.20%) was the most commonly involved organ followed by spleen (22.51%), bowel (15.58%), mesentery (8.23%), kidney (7.36%), pancreaticoduodenal injuries (3.46%) and diaphragm (3.46%). 56.71% underwent non-operative management (NOM), 3.90% underwent angio-embolization and 39.39% eventually required operative treatment. Mortality occurred in 31 patients (13.41%) because of septicemia, renal failure, shock, acute coronary event or respiratory complications.Conclusions: NOM for BAT was found to be successful in haemodynamically stable patient with solid organ injury. Along with sophisticated infrastructure like ultrasound or CT Scan, close supervision with repeated examination by a treating surgeon were the sheet anchors of NOM. Angio-embolization is a feasible modality of treatment in solid organ injury and can avoid surgery in an appropriate patient. Definitive indications for laparotomy were hemodynamic instability and perforation-peritonitis. Initial hemodynamic instability, haemorrhagic shock, and associated injuries influenced morbidity and mortality in BAT.

Blunt abdominal trauma and organ damage and its prognosis

Introduction: Trauma is the first cause of death in the young population and imposes large costs on the health system. Due to high rates of trauma and its associated mortality in developing countries, it seems to be necessary to study epidemiological and demographic characteristics of the damage caused by blunt abdominal trauma and common organs involved and the prognosis. Methods: All patients with blunt trauma of the abdomen who referred to Imam Reza Hospital, Tabriz, Iran, from March 2012 up to March 2014 were enrolled, the data were collected by a questionnaire for each patient separately; then all data was analyzed by SPSS. Results: From March 2012 to March 2014, 332 patients with blunt abdominal trauma came to the emergency department, mean age was 34.15 ± 1.6 years and 63.9% of them were men. In 290 cases (83.3%) there was not any damage to any organ. The most common injured organs were spleen and liver, equally 10 cases (3.0%). Kidney (2.4%) bladder (1.8%) and intestine (1.2%) were also involved. In this study, the most common cause of blunt abdominal trauma was a car crash. Conclusion: According to this study, men consisted 63.9% cases of blunt abdominal trauma and the mean age of patients was 34.15 ± 1.6 years. The most common cause of blunt abdominal trauma was car crash. In this study, 87.3% cases did not have any intra-abdominal organ damage. Among patients with intra-abdominal organ damage, spleen and liver were most commonly involved with equal incidence. About 79.5% of all patients with blunt abdominal trauma were discharged without complication and morbidity.

Evaluation of three phases computed tomography scan findings in blunt abdominal trauma

Introduction: Blunt abdominal trauma is one of the important types of trauma and causes mortality in patients. Identifying the internal organ damage is necessary to proper management of trauma patients. Computed tomography (CT) scan is a powerful non-invasive imaging technique to assess internal organ damages in blunt abdominal trauma. The aim of present study was to evaluate findings of CT scan with contrast in patient with blunt abdominal trauma. Methods: In this descriptive study, 290 patients with blunt abdominal trauma were studied who referred to emergency department of Imam-Reza Hospital of Tabriz University of Medical Sciences in Tabriz, Iran, from June 2014 to June 2015. Abdominal and pelvic CT scan with contrast was done using 1 detector CT scan machine in three phases (arterial phase, portal-venous phase and a delayed phase). Patients’ demographic information, cause of trauma, and CT scan findings were collected. Results: Mean age of patients was 26.3 ± 8.15 years. Male to female ratio was 1 to 0.42. Most common causes of blunt abdominal trauma were traffic accidents in 65.5% of patients, fall from height in 24.1% patients, and fall of heavy objects in 10.4% patients. Among all the patients, 57.6% had a detectable damage based on CT scanning. Based on CT scan findings, most common injuries were spleen injury in 20.0% of patients, liver injury in 18.9% of patients, and kidney injury in 8.9%. Conclusion: Traffic accidents were the most common cause of blunt abdominal trauma. Spleen, liver, and kidney injury were the most common internal organ damages based on CT scan findings.

An epidemiological study on pattern of thoraco-abdominal injuries sustained in fatal road traffic accidents of Bangalore: Autopsy-based study.

Background:The statistical profile reflects a global estimate of 5.1 million deaths in 2000, which was due to injuries that accounted for 10% of deaths due to all causes. Out of this, a quarter of injury-related deaths occurred in the South-East Asian region. Road Traffic Accident (RTA) is one among the top 5 causes of morbidity and mortality in South-East Asian countries. Most common cause of blunt abdominal trauma in India is road traffic accident followed by pedestrian accidents, abdominal blows, and fall from heights. Aims: To analyze the epidemiology and pattern of fatal thoraco-abdominal injuries in road traffic accidents.Materials and Methods:An autopsy-based cross-sectional study conducted. A purposive sampling technique was applied to select the study sample of 100 post-mortems of road traffic accident between November 2008 and May 2010 subjected to medico-legal autopsy at the department of Forensic Medicine, KIMS Hospital Bangalore.Results:The majority of the victims were aged 21 to 40 years, 50 (50.0%), most of the victims were male 92 (92.0%); and male/female ratio was 11.5:1. Commonest offending agents in heavy motor vehicles were 54 (54.0%). Bony cage sustained injuries were observed in 71; out of this, fractures of ribs were observed in 45 (63.3%) victims, clavicle in 14 (19.7%), sternum was 6 (8.4%), and vertebrae 6 (8.4%) of fatal road traffic accidents. Internal thoracic injuries were observed in 26 cases. Among internal thoracic injuries, lungs were the most commonly involved organ 24 (92.3%) followed by the heart 2 (7.6%). Lung sustained more lacerations 19 (79.1%) than contusions 5 (20.8%). Internal abdominal injuries were observed in 49 cases. In road traffic accidents, the most commonly injured abdominal organs were solid organs such as liver 16 (32.6%) followed by spleen 9 (18.3%).Conclusions:Majority of the times in road traffic accidents, young and productive males were injured or lost their life. This study may help the planners to take safety measures, to implement strict traffic rules, to risk stratification in the susceptible population to educate the people, and the study of nature of offending agent in RTA can help the authorities to plan better availability of health care on roads.

Blunt abdominal injury: a review of 59 consecutive cases undergoing surgery.

Abstract A consecutive series of 59 patients undergoing laparotomy as a result of blunt abdominal trauma is reported. Road-traffic accidents were the most common cause of blunt abdominal trauma and frequently produced a complex pattern of associated injuries. There were 8 deaths, giving a mortality-rate of 14 per cent. The number of associated injuries was the most important single factor influencing the mortality-rate. Delay in diagnosis occurred in 14 patients, and this may contribute to the high mortality-rate of blunt abdominal injury. A high index of suspicion, thorough and repeated clinical assessment, and willingness to resort to laparotomy are the main principles in the diagnosis of blunt abdominal injury.