Introduction

One of the most baffling problems of surgery can be a patient suspected of having blunt injury of abdomenial solid organs that requires surgical intervention as a life saving measure. Currently there are a few published data on pattern of solid organ injury of abdomen by blunt trauma, abdominal solid organ are liver, spleen, kidney, pancreas.

There is a good case to believe that in emergency situations the radiologists⁽¹⁵⁾ performance may profit from a systematic approach using established scoring systems. Score systems as the organ injury scale drawn up by the American Association for the Surgery of Trauma (AAST) are a valuable guidance for objective trauma assessment. When isolated organ injuries were examined, there were statistically significant increases (p < or = 0.05) in all outcomes variables corresponding with increasing OIS grade.⁽¹⁶⁾

In Indian set up very poor people come to hospital. Every patient is not affordable for CT scan and CT scan not available at peripheral centers for blunt trauma abdomen. So in our study we have compared USG and CT abdomen finding in abdominal trauma patients. So as to decide whether USG alone (clinically stable patients) is equivalent to CT abdomen in low resource setting.

Material & Methods

All solid organ injury of abdomen of above 14 yr age group by blunt trauma admitted in routine & emergency hours in general surgery in M.Y. Hospital, Indore, in duration January 2016- July 2017 were included. The diagnostic methods used in the study are USG abdomen, CECT abdomen, X-RAY ABDOMEN ERECT, X ray chest etc.

Results

The present study included 100 cases of blunt abdominal trauma admitted to Emergency surgery & Trauma unit, Department of Surgery, M.Y. Hospital Indore from 1/1/2016 to 1/1/2017.

1. Committee on Trauma, American College of Surgeons, National Trauma Data Bank annual report 2016, American college of surgeons.
2. Mehta N, Babu S, Venugopal K An experience with blunt abdominal trauma: evaluation, management and outcome 2014 Jun 18;4(2):599. doi: 10.4081/cp.2014.599. e Collection 2014.
3. Jones EL, Stovall RT, Jones TS, Bensard DD, Burlew CC, Johnson JL, Jurkovich GJ, Barnett CC, Pieracci FM, Biffl WL, Moore EE Intra-abdominal injury following blunt trauma becomes clinically apparent within 9 hours. 2014 Apr; 76(4):1020-3. doi: 10.1097/TA.000000
4. Howes N, Walker T, Allorto NL, Oosthuizen GV, Clarke DL. Laparotomy for blunt abdominal trauma in a civilian trauma service. 2012 Mar 29;50(2):30-
5. Onder A, Kapan M, Tekbas G, Arikanoglu Z, Aliosmanoglu I, Taskesen F, Girgin S. Blunt trauma - related isolated pancreatic injury. 2013;114(9):519-22.
6. Haulik L, Tóth B, Issekutz A, Gartner B. [Pancreatic injury in blunt abdominal trauma: early versus late diagnosis and surgical management]. 2001 Oct;54(5):309-13.
7. Fernandes TM, Dorigatti AE, Pereira BM, Cruvinel Neto J, Zago TM, Fraga GP. Nonoperative management of splenic injury grade IV is safe using rigid protocol. 2013 Jul-Aug;40(4):323-9.
8. Cirocchi R, Corsi A, Castellani E, Barberini F, Renzi C, Cagini L, Boselli C, Noya G. Case series of non-operative management vs. operative management of splenic injury after blunt trauma. 2014 Mar;20(2):91-6. doi: 10.5505/tjtes.2014.99442.
9. Prichayudh S, Sirinawin C, Sriussadaporn S, Pak-art R, Kritayakirana K, Samorn P, Sriussadaporn S. Management of liver injuries: Predictors for the need of operation and damage control surgery. 34.2014 Sep;45(9):1373-7. doi: 10.1016/j.injury.2014.02.013. Epub 2014 Feb 15.
10. Balcıoğlu ME, Boleken ME, Cevik M, Savaş M, Boyacı FN. Blunt renal trauma in children: a retrospective analysis of 41 cases. 2014 Mar;20(2):132-5. doi: 10.5505/tjtes.2014.65392
11. Mehmet Selim Nural, Türker Yardan, Hakan Güven, Ahmet Baydın, İlkay Koray Bayrak, Celal Katı DiagnIntervRadiol 2005; 11:41-
12. Kshitish Mallik, SushmaVashisht, Sanjay Thakur, DN Srivastava Dept of Radiodiagnosis, AIIMS, New Delhi - 110 029, India Year : 2000;10(4): 237—243.
13. Liu, Ming MD; Lee, Chen-Hsen MD; P & apos;eng, Fang-Ku MD
14. Govender M, Madiba TE. Current management of large bowel injuries and factors influencing outcome. 2010 Jan;41 (1):58-63. doi: 10.1016/j.injury.2009.01.128
15. Homann G¹, Toschke C, Gassmann P, Vieth V.Chin J Traumatol.2014; 17(1):25-30.
16. Tinkoff G¹, Esposito TJ, Reed J, Kilgo P, Fildes J, Pasquale M, Meredith JW. J Am Coll Surg.2008 Nov;207(5):646-55. doi: 10.1016/j.jamcollsurg.2008.06.342. Epub 2008 Aug 30.
17. Arikanoglu Z, Turkoglu A, Taskesen F, Ulger BV, Uslukaya O, Basol O, Aldemir M. Factors affecting morbidity and mortality in hollow visceral injuries following blunt abdominal trauma.14;165(1):23-6. doi: 10.7417/CT.2013.1656
18. Arslan S, Güzel M, Turan C, Doğanay S, Doğan AB, Aslan A Management and treatment of liver injury in children.2014 Jan;20(1):45-50. doi: 10.5505/tjtes.2014.58295

Dr Atul Kumar Patel (MS General Surgery)