Clinical study of hollow viscus and solid organ injury in blunt abdominal trauma and its management

Abdominal injury as a result of both blunt and penetrating trauma has an appreciable mortality rate from haemorrhage and sepsis. This study represents the experience with blunt trauma to the abdomen of patients from a tertiary care centre. The study was undertaken to know the demographic details, mode of injury, management and outcome of blunt trauma abdomen (BTA). All the blunt trauma abdomen cases admitted in RIMS Ranchi during periodof July 2014 to September 2016. There were 55 consecutive cases of blunt trauma abdomen. Most common age group involved was 30-40 years followed by 20 to 30 year. Male and Female ratio was 3:1. Most common mode of injury was RTA 47.2%. Diagnosis was established in all cases by clinical examination, X-ray, ultrasound or CECT. Spleen (49%) was the commonest organ injured next Liver (21.8%). 67.2% (37patients) of cases underwent successful conservative treatment and 32.7% (18) operative treatment. Mortality was 10%.Non operative management (NOM) for BTA was found to be highly successful and safe. Definitive indications for laparotomy were hemodynamic instability and peritonitis. Patients with initial Hemodynamic instability are associated with a high risk of NOM failure. USG (FAST scan) in haemodynamically unstable patients as compared to CECT in stable patients were investigations of choice. Associated injuries influenced morbidity and mortality.