Comparative Analysis of Nonpenetrating and Penetrating Abdominal Injuries

Velmurugan, K (2017) Comparative Analysis of Nonpenetrating and Penetrating Abdominal Injuries. Masters thesis, Madras Medical College, Chennai.

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Abstract

Trauma is an accidental or intentional injury caused by of energy which is usually mechanical in nature to a victim 1% of hospital admissions for trauma involve the Abdomen. Several abdominal injuries are common in patients with multiple injuries. Trauma to the abdomen are classified as PENETRATING and NONPENETRATING. While penetrating injuries are common in urban Places, nonpenetrating is common in civilian trauma victims. Damage to organs can occur in both penetrating and non-penetrating trauma. The sudden application of pressure in non penetrating trauma is more likely to rupture solid Organ. While penetrating trauma causes more injury to hallow viscus. Two major life threatening situations occur following organ injury in both penetrating and non-penetrating trauma are HAEMORRHAGE and HOLLOW VISCUS PERFORATION with associated chemical and bacterial peritonitis. AIM AND OBJECTIVES: To do a comparative observational study of organ injuries and sequalae in penetrating and non penetrating abdominal trauma patients admitting in trauma ward, Rajiv Gandhi Government General Hospital and emergency laparotomy done, in the following aspects. a. Single & Multiple Organ injuries-incidence, effects and sequalae. b. To know the various epidemiological factors related to trauma. c. To know the cause and mode of injury in organ injuries. d. Complications of various organ injuries. To determine the cause, presentation, anatomical distribution of abdominal trauma. MATERIALS AND METHODS: This comparative study was done in RGGGH CHENNAI during the period September 2015 to September 2016. 45 consecutive cases of abdominal trauma was chosen from this department, these 45 cases were classified into penetrating and non penetrating types according to the standard classification. All abdominal trauma patients were received by the Casualty Medical Officer (both MLC and non MLC) and these patients were admitted in Napier Ward, where the Duty Assistant Surgeon attended the patients. Resuscitative measures and the baseline investigations were done simultaneously. Careful history was elicited from the patients, if consciousness was altered, history was elicited from the attender of the patient. Thorough clinical examination was done. Age, Sex, IP No, mode of injury were noted. General examination of the patient was carried out. Pallor and hydration looked for in particular. On gross examination head injury, fracture ribs, fracture longbones or Pelvic fracture were looked for. A thorough abdominal examination was done. External bruise or abrasion were noted in particular for non penetrating trauma. In case of penetrating trauma, external wounds, evidence of peritoneal penetration, evisceration of omentum or viscera were noted. Signs of peritonitis or internal haemorrhage was looked for and noted in both types of abdominal trauma. Serial abdominal girth measurements, half hourly pulse, temperature, respiration and hourly BP chart were maintained in relevant cases. Base line blood investigations and radiological examination done in all cases. Tetanus Toxoid was given to all patients. All cases were given antibiotics parenterally. Diagnostic peritoneal tap was done in relavant cases. CONCLUSION: The following conclusions were drawn from this study; • Non penetrating trauma is more common than penetrating trauma. • Solid organ injury is common in Non Penetrating Trauma. • Hollow viscus injury is common in Penetrating Trauma. • Spleen is the commonest organ affected in Non Penetrating Trauma. • Liver injuries in this study are not very serious and they are treatable. Extensive liver injuries are potentially dangerous. • Hollow viscus like jejunum.ileum, colon, stomach are the common organs affected in penetrating trauma • Mortality and morbidity depends on delay in treatment, number of organs affected, number of injuries in each organ and which organ is affected. • Omentum is commonest structure to be prolapsed in wound site in penetrating trauma. • Bladder is the common organ associated with pelvic bone fractures. • wound infection is the common complication in the penetrating trauma.

Item Type: Thesis (Masters)
Uncontrolled Keywords: PENETRATING and NON-PENETRATING more common in abdominal trauma emergency management, improve the reduction of mortality rate.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 18 Mar 2020 16:51
Last Modified: 18 Mar 2020 16:51
URI: http://repository-tnmgrmu.ac.in/id/eprint/12329

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