CLINICAL COURSE AND OUTCOME OF PATIENTS WITH SOLID ORGAN INJURY IN BLUNT ABDOMINAL TRAUMA

Abstract

Background: Blunt abdominal trauma, one of the most common injuries caused by road traffic accident are usually not obvious hence often missed unless repeatedly looked for. In view of this, the study was aimed to diagnose the solid organ injury and its incidence, mode, age, sex distribution, time of presentation, clinical course, management, time interval between injury and surgery, postoperative complications and outcomes.

Methods: This prospective observational study was conducted in the department of General surgery, Chitwan Medical College Teaching Hospital, from August 2020 to July 2021. Data were collected with clinical history/examination, injury assessment, appropriate investigations, modes and patterns. Documentation with identification, history, clinical findings, diagnosis, management, complications and outcomes were done and analyzed with SPSS version 16.

Results: Among 83 patients, most of them aged between 16-30 years (57.8%). Male to female ratio was 1.96:1. The most common mode was road traffic accidents (55.5%). Commonly injured organ was spleen (51%) and liver (30%) with associated other organs (65%). Conservative management was done in 62% and operative in 38%. Majority of patients were operated after 4-6 hours of initial presentation. The more the time interval between injury and surgery, the more the complications, duration of hospital stay and mortality. Post-operative complications were noted in 38.5% and mortality in7.22%.

Conclusions: Blunt abdominal trauma was common and mainly associated with road traffic accidents. Associated abdominal and extra abdominal injury, delay presentation, diagnosis and intervention significantly predict high mortality and poor outcomes.