Asian Journal of Research in Surgery

A Prospective Study on Non-Operative Management of Solid Organ Injuries in Blunt Abdominal Trauma Patients

Binoy Kumar Behera *

Department of General Surgery, PDU Medical College & Hospital, Rajkot, India.

Hetvi Marsonia

Department of General Surgery, PDU Medical College & Hospital, Rajkot, India.

Jatin. G. Bhatt

Department of General Surgery, PDU Medical College & Hospital, Rajkot, India.

Jignesh P. Dave

Department of General Surgery, PDU Medical College & Hospital, Rajkot, India.

J.G. Vagadia

Department of General Surgery, PDU Medical College & Hospital, Rajkot, India.

*Author to whom correspondence should be addressed.

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Abstract

Introduction: Following injury to the extremities and head, abdomen is the third most commonly injured part of the body. Blunt abdominal trauma (BAT) is particularly deceptive because of the delay in clinical manifestations for hours or even days, even though the damage to the internal organs might be serious and lethal. The road traffic accident (RTA) is the most common mode of injury to cause blunt abdominal trauma. Diagnostic modalities like FAST and CT scans have caused a significant change in trends regarding management from surgical to a more conservative approach. Our current research aimed at examining the pattern of blunt injury to the abdomen, the mode of injury, and the involvement of various abdominal solid organs, investigating various investigational modalities and their use in the management of blunt abdominal trauma, and examining post-traumatic management with regard to non-operative treatment modality.

Materials and Methods: This prospective study is based on 100 cases of Blunt abdomen trauma who presented in P.D.U. Medical College & Hospital, Rajkot with respect to clinical presentation, investigations, management and outcome. Results and outcomes are depicted in various tables and figures.

Results: In the present study, demographic data like age and sex, the mode of injury, commonly injured solid organs, management done and the associated other treatment parameters was observed and compared. It was found that Blunt abdominal trauma commonly involves young males in the age group of 20 - 30 years. RTA is found to be the most common mode of injury. Liver was the most commonly injured solid organ followed by spleen. Around 27% of total cases have associated other organ system injuries in addition to blunt trauma to abdomen. Non-operative management was successful in 92 out of 100 patients with an average length of the hospital stay around 6 days.

Conclusion: Peak incidence of Blunt trauma abdomen is in young males and productive age population. All abdominal solid organ injuries can be given a trail of non-operative management whenever the patient is stable. Liver and spleen have favorable outcome when managed conservatively. Non-operative management is widely accepted in hemodynamically stable blunt abdominal trauma patients.  The basic principle of non-operative management is close clinical follow-up of the patient. The non-operative treatment efficacy in well in this study regardless of the type of injury. Early diagnosis, aggressive resuscitation and timely surgical intervention may improve the outcomes for trauma patients.

Keywords: Organ injuries, abdominal trauma, road traffic accident, abdominal injuries, haemorrhage

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