Parikshit Sadagopan, Jacob Jayakar Raju Mandapati, Sampath Kumar Poral
BACKGROUND Blunt trauma abdomen is one of the most common emergencies faced by surgeons all over the world. The leading cause of blunt trauma abdomen is road traffic accidents followed by assaults and fall from height. Approximately 10% of injuries requiring laparotomy are the result of blunt trauma abdomen. The emphasis in treatment of blunt trauma abdomen has gradually shifted from operative management to conservative management. This has been possible by the increased use of computerized tomography in the evaluation of blunt trauma abdomen as opposed to the bedside techniques like four quadrant aspiration and diagnostic peritoneal lavage. A positive diagnostic peritoneal lavage is no longer an indication for laparotomy. This study was conducted to know the pattern of solid organ injuries seen in patients with blunt trauma and also to evaluate their management. MATERIALS AND METHODS This is a prospective clinical, hospital-based study of 67 patients conducted in Pondicherry Institute of Medical Sciences for a period of 18 months. Patients less than 12 years of age and with penetrating injuries were excluded from the study. RESULTS A total of 67 patients presented with pain abdomen and were included in the study with clinical suspicion of blunt trauma abdomen. Of these 26 (39%) were found to have internal abdominal solid organ injury. Male was the predominant gender at 87%. Road traffic accident was the most common mode of injury at 87%. Spleen was the most common solid organ involved in blunt trauma 12 (46%). Followed by liver 6 (31%). Out of the 26 patients with solid organ injury, 7 (27%) patients underwent laparotomy and 19 (73%) were managed conservatively. There was one death in our study. The patient died soon after presenting in casualty with hypovolemic shock. Post mortem revealed liver laceration. CONCLUSION Spleen was the most common organ injured in blunt trauma abdomen. 73% of the patients with solid organ injury were managed successfully with conservative management which shows that conservative management is the preferred method of treatment in blunt trauma abdomen with solid organ injury.
