Year: 2024
Type: article
Study design: Observational Study
Abstract: Background: Injury, or trauma, is defined as cellular disruption brought on by external energy that exceeds the body’s capacity for recovery, which is exacerbated by cell death from ischemic reperfusion. Trauma is still a major cause of death, especially for people between the ages of 1 and 44 (it accounts for 8% of all deaths in India). 15–25% of trauma-related deaths are related to abdominal trauma. This type of trauma frequently results in hemoperitoneum, making prompt diagnosis difficult due to comorbidities. With the support of sophisticated imaging, non-operative therapy has emerged as the recommended strategy for patients who are hemodynamically stable. The development of trauma centers with modern facilities is intended to reduce morbidity and mortality, signifying a change in focus towards proactive healthcare. Methods: 50 randomly selected cases of blunt abdominal injuries that presented at a tertiary care teaching hospital were examined in this prospective observational study. Patients with proven single or multiple abdominal solid organ injuries, with or without concomitant injuries, who were 12 years of age or older met the inclusion criteria. Patients received primary resuscitation, investigations, and trauma center management in according to Advanced Traumatic Life Support (ATLS) standards. In order to collect data, a proforma was used to record the history, examination, and investigations. In the outpatient department, patients visited once a week for the first month following their discharge and once a month for the next five months. Results: According to the study, blunt abdominal trauma from Road Traffic Accidents (RTAs) is most common in males between the ages of 20 and 40. Within six hours of the injury, 54% of patients were admitted to tertiary care hospitals. The most frequent damage were to the the spleen (62%) followed by liver and kidney. In 21 cases, surgical intervention was necessary, mostly for higher grade injuries; the most frequent surgery was a splenectomy. When it came to low-grade and single solid organ injuries, conservative therapy fared better. The most frequent postoperative consequence was surgical site infection, which led to an average hospital stay of 9.28 days for operated patients as opposed to 6.27 days for conservatively managed patients. Mortality occurred in 10% of individuals throughout treatment. Conclusions: Blunt abdominal injuries, primarily caused by vehicle collisions, require greater observance of traffic laws in order to lessen the increasing burden. Treatment is still complex and requires a CT scan for a quick diagnosis, although FAST helps patients who are hemodynamically unstable. For stable patients (Grades 1-3), conservative approach has good results; however, ideal protocol to be followed in unstable or higher grade injuries (Grade 4-5) is surgical management. In order to improve results, medical teams must work together, with a focus on early presentation to tertiary care institutions for the best management during the “Golden hour.”
Authors: Nilesh J Patel, Harshiv B. Desai, Deep P. Mehta, Devesh C. Prajapati
Institution: Smt. N.H.L. Municipal Medical College
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7105543580
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