Blunt Abdominal Trauma: Making Decision of Management with Conventional and Ultrasonography Evaluation

International Journal of Medical Science

© 2014 by SSRG - IJMS Journal

Volume 1 Issue 2

Year of Publication : 2014

Authors : Dr.Naveen K G , Dr. Ravi N and Dr. Nagaraj B R

10.14445/23939117/IJMS-V1I2P101

How to Cite?

Dr.Naveen K G , Dr. Ravi N and Dr. Nagaraj B R, "Blunt Abdominal Trauma: Making Decision of Management with Conventional and Ultrasonography Evaluation," SSRG International Journal of Medical Science, vol. 1,  no. 2, pp. 1-10, 2014. Crossref, https://doi.org/10.14445/23939117/IJMS-V1I2P101

Abstract:

Blunt abdominal trauma is one of the commonest causes of morbidity and mortality in modern era. Road traffic accidents; fall from height, assaults are the commonest modes of Blunt abdominal trauma. Rapid diagnosis was essential and appropriate diagnostic work up and treatment is critical to ensure patient survival to decrease mortality and morbidity. The recent trend of management is in favor of conservative surgical management of abdominal solid visceral injuries. However the feasibility and safety of such an approach especially in a limited resource setup, skilled man power and non availability of intensive care units and advanced imaging/instrumental technique like CT, angiography Etc like rural setups. Majority of these patients were involved in road traffic accident. In this study out of 100 patients 96 were positive for solid organ injury and 4 had mesenteric injury. Abdominal sonography had a sensitivity of 96.8%, specificity of 100% and negative predictive value of 57% in diagnosing solid organ injury. 6 cases of intestinal perforation on plain abdominal radiographs showed air under diaphagram. Multipronged multimodality approach employing combination of abdominal radiographs, ultrasonography in evaluating trauma cases can be fairly useful , where limited diagnositic modalities lacking CT and ICU support skilled surgeons , angiography etc and cost effective.

Keywords:

Blunt abdominal trauma, ultrasonography, CT (computed tomography), solid visceral organs.

References:

[1]C. Keith Stone, Roger L. Humphries. Current diagnosis & treatment: Emergency  Medicine, 6th Edition. Mcgraw-hill Medical   Publishing; 2007.
[2]Mohapatra S, Pattanayak SP, Rao KRRM, Bastia B. Options in the management  Of solid  Visceral   injuries from blunt abdominal trauma. Indian J Surg    2003;65:263-8.
[3]Centers for Disease Control and Preven-tion, National Center for Injury Prevention and Control. Web-based Injury Statistics  Query and Reporting System (WISQARS) 
[4]Hughes TM, Elton C. The pathophysiology  and management of bowel and mesenteric  injuries due to blunt trauma. Injury 2002; 33(4):295–302.
[5]Cox EF. Blunt abdominal trauma. A 5-year  analysis of 870 patients requiring celiotomy.  Ann Surg 1984;199(4):467–474.
[6]Feliciano DV. Patterns of injury. In: Feliciano  DV, Moore EE, Mattox KL, eds. Trauma.       Stamford, Conn: Appleton & Lange, 1996;  85–103.
[7]injury and pelvic fractures James J. McCort , Robert E. Mindelzun Emergency Radiology 01/1994; 1(1):47-51. DOI: 10.1007/BF02628776)
[8]Feliciano DV. Diagnostic modalities in abdominal trauma. Peritoneal lavage, ultrasonography, computed tomography scanning, and arteriography. Surg Clin North Am 1991; 72:241-56.
[9]McAnena OJ, Moore EE, Marx JA. Initial evaluation of the patient with blunt abdominal trauma. Surg Clin North Am 1990;70:495-515.
[10]Boulanger BR, McLellan BA, Brenneman FD, Ochoa J, Kirkpatrick AW. Prospective evidence of the superiority of a sonography-based algorithm in the assessemtn of blunt abdominal injjury. J Trauma 1999;47:632-7.