Penetrating abdominal. 1trauma.pdf

EC Gastroenterology and Digestive System, 2018

Abstract Keywords: Abdomen; Open Trauma; Blunt Trauma; Etiology; Shock; Stability; Surgery Introduction: Closed and isolated abdominal injuries occur infrequently during an accident and when they do occur they do not always require immediate surgical intervention. Material and Method: An observational, retrospective and cross-sectional study of patients with abdominal trauma was conducted over a period of four years. Inclusion criteria: all open and closed abdominal traumas of any age, of both sexes and by any etiology. Exclusion criteria: polytraumatized patients, cranioencephalic trauma and orthopedic trauma without abdominal involvement. Results: During the study period, 38 cases of abdominal trauma were collected. Upon admission, 5 patients were reported in shock and 33 were stable. 28 cases with open abdominal trauma and 10 with closed abdominal trauma. 29 cases were exclusively abdominal and 9 cases were thoracoabdominal. 3 tomographies and 6 ultrasounds were taken, 1 case was self-inflicted lesion. Isolated abdominal injuries occur infrequently during an accident and when they do occur they do not always require immediate surgical intervention. Currently, there is a tendency to preserve organs and in some countries, surgeons are rarely faced with these situations, but not in countries with social problems or high marginalization, so that surgeons in these countries should be able to interpret correctly the mechanisms of the lesions, adequately estimate the signs and symptoms and the physical examination, the radiological findings and establish whether the patient requires surgical intervention [1]. Introduction On the other hand, evaluation systems such as the ATLS have not been validated with rigorous randomized controlled studies before and after the trauma and their value leaves doubts about their effectiveness despite having been established in almost all the world but continues to be used as a tool in the absence of another system or even when its validity is undoubtedly demonstrated [2-5]. In Mexico, general surgeons continue to be very important in general hospitals due to the resolutive capacity they have to attend, in addition to the conventional surgical resolution conditions, traumatic disorders normally healthy and/or with other comorbidities, i.e. a patient that we did not previously know and that we must attend to abdominal and/or thoracic injuries regardless of age or gender. Discussion: Abdominal trauma is divided into open and closed and because their diagnosis is different, the decision to operate or not to operate and the time to operate vary from case to case. In one study they found that the main cause of trauma was due to motor vehicles and falls and its main presentation was closed abdominal trauma. In our study, the main presentation was open trauma and the main cause was caused by a knife. Another study found that the main cause was the injury by firearm, which is not our case since we only had 2 cases in the last year.

Scholars Report, 2018

sUMMAry Introduction: Patients with open or penetrating abdominal trauma are usually subjected to exploratory laparotomy, however, in selected cases, many surgeons decide not to operate and keep their patients under observation since this expectant attitude has avoided unnecessary laparotomies throughout the world. Material and Method: An observational, retrospective and cross-sectional study of open abdominal trauma was conducted over a period of four years. Inclusion criteria: all open abdominal traumas of any age, of both sexes and by any etiology. Exclusion criteria: closed abdominal trauma, multiple trauma patients, cranioencephalic trauma and orthopedic trauma without abdominal involvement. Results: During the study period, 38 cases of abdominal trauma were collected, of which 26 were open. Seventeen male and nine female cases. At admission, two patients were reported in shock and 24 were stable. Twenty-two cases were exclusively abdominal and four cases were thoraco-abdominal. Twenty-two cases were by the knife; two cases per firearm; two cases per rods. Three patients required a transfer to the ICU (splenectomy, iliac artery injury, and packaging). There were no deaths. Discussion: The decision to intervene surgically depends on whether the patient is stable or unstable, in the first case there is time to do the necessary studies, in the second the patient should be laparotomized to control the bleeding that causes the patient's state of shock. In our hospital, we have a shock unit and this helps greatly for the primary care of the injured and its evaluation by surgery.

Albanian Journal of Trauma and Emergency Surgery

Introduction: Blunt abdominal trauma (BAT) is one of the most common traumatic emergencies and is associated with significant morbidity and mortality, which is associated with a number of causes despite improvements in their management. This study aims to assess 308 cases of BAT and their management depending on the number of Injured organs. Material and Methods: The study has a retrospective character and it has been realized within the period of time from January 20016 to December 2018. In our study are included 308 trauma cases admitted at the University Hospital of Trauma in Tirana Albania. All recorded data were grouped as follows; Demographic data, trauma mechanism, admission time in hospital, the mode of management… Results: The sample of the population was chosen by chance which means that this study is included all trauma cases presented at the emergency department and hadn’t any study limitation. In our study, based on the mechanism of trauma, motor vehicle accident [191(6...

ScholarsReport, 2018

sUMMAry Introduction: It has long been thought that patients with open abdominal trauma should undergo surgery as soon as their clinical conditions permit, and that closed abdominal traumas put the surgeons in a dilemma whether or not they should operate and when they doubted the results could be catastrophic. Material and Method: An observational, retrospective and cross-sectional study of all patients with closed abdominal trauma in a general community hospital of the second level was conducted over a period of four years. Inclusion criteria: all closed abdominal traumas of any age, of both sexes and by any etiology. Exclusion criteria: open abdominal trauma, multiple trauma patients, cranioencephalic trauma and orthopedic trauma without abdominal involvement. Descriptive statistics were used for the results obtained. Results: During the study period, 38 cases of abdominal trauma were collected, of which nine were closed. Eight male and one female cases. At admission, two patients were reported in shock and seven were stable. Five cases were exclusively abdominal and four cases were thoraco-abdominal. Discussion: Closed abdominal trauma presents a diagnostic challenge and for the surgical evaluation of patients with closed abdominal trauma, a reliable physical examination is not possible when patients have concomitant injuries that cause disturbing pain, or when patients are unconscious. Exploratory laparotomy is necessary for up to 10% of patients with closed abdominal trauma and is only necessary when there is solid organ injury and the patient is hemodynamically unstable, with its exceptions.

Journal of Emergency Practice and Trauma

Introduction Abdominal trauma has been described as a disease in evolution and a cause of considerable morbidity and mortality among trauma patients (1). About a third of trauma patients worldwide have abdominal trauma which accounts for a significant fraction of tragic loss of life (2). According to the World Health Organization (WHO), trauma will become the first or second leading cause of loss of productive years of life for both developed and developing countries by the year 2020 (3). There is a rise in the incidence of abdominal injuries globally, and there are regional and worldwide variations in the aetiological factors associated with abdominal trauma (4,5). These factors include, but not limited to, civil and political violence, armed robbery attacks, increased automobile crashes, insurgency and global terrorism. Abdominal trauma may also arise from recreational activities like contact sports, and workplace and domestic incidents like fall from height. The health problems arising from automobile crashes remain unquantifiable especially in developing countries where those at the prime of productive life are often involved. In our subregion, this becomes more pronounced amongst youths who use motorcycles for commercial transportation services without any formal training or certification (6). Abdominal trauma is generally classified as either blunt or penetrating. Blunt injuries may result from vehicular crashes, warfare injuries, battering, fall from heights, sports accidents, martial arts, athletics and mountaineering while penetrating types are usually secondary to stab, arrow and spear, firearms and gunshot injuries (7). The diagnosis of penetrating abdominal trauma is usually easy and reliable but blunt abdominal trauma is a real challenge even for experienced trauma and general surgeons as some injuries may not manifest during the initial assessment and treatment period. This is made

Clinical Surgery - A Practical Guide [Qassim Baker, Munther Aldoori]

IOSR Journals , 2019

Background: The Aristotle has been given the credit of being the first to describe visceral injury from non penetrating trauma. Most of the ancient accounts concerns about penetrating organ injuries and their well known Mortality. Aim: 1.Age/sex distribution 2. Type of injury (blunt injury / penetrating injury) 3.Organ involvement 4.Mode of injury (assault ,accidents, fall, etc.) Methods: Total of 52 cases of abdominal trauma [blunt and penetrating trauma] was analysed during the period of last 24 months (January 2017 to November 2018) in tertiary level care hospital. All patients who were admitted in oursurgery department after abdominal trauma were included in this study. Results: In this study, most common age group involved is 21-30 age group, sex distribution of male:female ratio is (9.9:1), with blunt injury abdomen more common than penetrating injury mostly involving single organ injury. Road traffic accident is the most common cause of abdominal injury. Thoracic injury is more commonly associated with abdominal injury. Based on the patient condition and radiological findings 56% of cases were treated by emergency laparotomy for organ injury and 44% of patients were managed conservatively.

International Journal of Medical Science and Public Health, 2015

Background: Abdominal trauma is one of the most common injuries among injuries caused mainly due to road traffic accidents. The rapid increase in motor vehicles and its aftermath has caused rapid increase in the number of victims to blunt abdominal trauma (BAT). Motor vehicle accidents account for 75%-80% of BAT. The knowledge in the management of BAT is progressively increasing due to the inpatient data gathered from different parts of the world. In spite of the best techniques and advances in diagnostic and supportive care, the morbidity and mortality remains at large. The reason of this could be due to the interval between trauma and hospitalization, delay in diagnosis, inadequate or lack of appropriate surgical treatment, postoperative complications, and associated trauma especially to spine, head, thorax, and extremities. Objective: To study the blunt and penetrating abdominal trauma, its various patterns of injuries, and its management. Materials and Methods: After initial resuscitation of the trauma victims, a careful history was taken to document any associated medical problem. Documentation of patients, which included identification, history, clinical findings, diagnostic test, operative findings, operative procedures, and complications during the stay in the hospital and during subsequent follow-up period, was recorded on a Performa specially prepared. The decision for operative or nonoperative management depended on the outcome of the clinical examination and results of diagnostic tests. Patients selected for nonoperative or conservative management were placed on strict bed rest and subjected to serial clinical examinations that included hourly pulse rate, blood pressure, respiratory rate, and repeated examination of abdomen and other systems. Result: The most common age group involved in BAT was between 13 and 20 years, whereas in penetrating abdominal trauma was between 21 and 30 years. This study showed that of 100 cases of abdominal trauma, 19 were presented with shock (blood pressure <100 mm Hg) while 30 had blood pressure between 100 and 110 mm Hg. Following BAT of 75 patients, 48 managed conservatively while 27 undergone operative management. Following penetrating abdominal trauma of 25 patients, only one managed conservative whereas all other required exploration. Conclusion: The best way of reducing the morbidity and mortality from BAT is prevention. There is an acute need of trauma center that is well equipped with all modern facilities in tertiary care center.

The aim of the present study is to study the mode of injury and the clinical presentation of Blunt injury abdomen and the presence of associated injuries and to study the methods of evaluation, decision making and management in these cases.Patients and methods: This hospital based prospective clinical study includes60 patients of blunt abdominal trauma of various intra-abdominal lesions which reported to Siddhartha Medical College and General Hospital between July 2016 to December 2017. Results: Majority of these patients (70 %) were in the age group of 11-40 years, which is a period of activity. Males outnumbered females, the ratio being 5:1, only 10 out of 60 patients were females. Majority had a history of Road traffic accident and abdominal pain and tenderness, guarding and rigidity were noted most often. Most of the patients with simple abdominal injuries had an average hospital stay of about 10 days.Overall accuracy of diagnostic peritoneal tap is about 62.5%.

Journal of Evolution of Medical and Dental Sciences

BACKGROUND In spite of the advancement in medical technology, trauma remains a major health threat causing significant mortality and morbidity worldwide. The aim of this study was to evaluate the incidence and cause of the various abdominal injuries and compare the incidence, management, and outcome of blunt trauma and penetrating trauma abdominal injuries. METHODS Total 99 patients who had visited the surgery department BRD Medical College, Gorakhpur, U. P., from April 2016 to March 2017 (one-year period) were included in this prospective study. Both blunt as well as penetrating trauma patients were included in the study. After recording a detailed history, all relevant laboratory and radiological investigations were done. Depending on the initial test reports, patients underwent either operative or conservative treatment. Postoperative complications, if any, were also recorded. RESULTS In the present study, majority of patients were in 11-20 years age group. Male to female ratio was found to be 5:1. Blunt trauma is more common than penetrating trauma with a ratio of 3.7:1, and in penetrating trauma stab injury is more common than gunshot injury with a ratio of 3:1. In blunt trauma abdomen, road traffic accident was the most common mode of injury (57.7%) followe d by falling from a height (30.8%) and assault (10.2%). In penetrating trauma abdomen, assault is the most common mode of injury (81%) followed by a road traffic accident (9.5%). Pain abdomen was the most common symptom (100%) in both groups. Most of the patients were treated by conservative management in both groups. A low mortality rate was reported in the present study (3.3%). CONCLUSIONS Abdominal trauma is one of the major health hazards among the younger male population. The most common mode of abdominal trauma is road traffic accident in the blunt trauma group, whereas in the penetrating group, gunshot and stabbing were the most common causes of injury. Conservative therapy was the most common mode of treatment in both groups. No major organ injuries were seen during radiological investigations.