Pandian, P (2006) Blunt Injury Abdomen: An Evolution of Solid Orgons. Masters thesis, Thanjavur Medical College, Thanjavur.
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Abstract
INTRODUCTION: Trauma has come to occupy a prominent position as one of the preventable cause of death. In developed countries trauma to the abdomen is mainly due to road traffic accidents. In our country also it is major health problem. Analysis of these accidents show that mostly alcohol intoxication and violation of traffic rules is the cause in 85 % of cases. Abdomen is the third most commonly injured part of the body next to injuries to extremities and head injuries. Blunt injury to the abdomen causes single organ injury or multiple organ injury according to the severity of the accident. Our Thanjavur District, Granary of South India, due to increased agricultural activities the injury occurred during agricultural work more or less equals to that of road traffic accidents. Hence, the pattern of injury of to the solid organ was also taken as a comparative study of road traffic accidents and agricultural related injuries. AIM OF THE STUDY: 1. To evaluate the impact of blunt abdominal trauma on various intra abdominal solid such as liver, spleen, pancreas and kidney with regard to age, sex and various modes of blunt injuries. 2. To evaluate various associated injuries occurring in blunt abdominal trauma. 3. To evaluate various modes of clinical presentation of cases with solid organ injuries in blunt abdominal trauma with emphasis on the clinical signs as the prime tool in the early diagnosis. 4. To evaluate the value of various available investigations employed for detection of the solid organ injuries in blunt abdominal trauma. 5. To evaluate the common patterns of injury in the blunt abdominal trauma. 6. To analyze various modalities of treatment available for solid organ injuries with an aim to reduce the postoperative morbidity and mortality. 7. To evaluate the common complications associated with solid organ injuries and their management. 8. To compare the incidence and mode of injuries due to agricultural and agricultural related activities with that of road traffic accidents. MATERIALS AND METHODS: Forty-Five cases of blunt abdominal trauma with solid organ injuries admitted in all surgical units at Thanjavur Medical College Hospital, Thanjavur during the period of July 2003 to November 2005 were taken for this study. The cases were selected in such a way that only those patients with definitive history and clinical findings suggestive of injury to solid organs which were later confirmed by investigations and/ or laparotomy/ autopsy. Detailed history regarding the mode and nature of injure were taken, time elapsed between the time of injury to the time of admission in the hospital and the time of injury to the time of operation were analysed. The clinical features were studies in detail with special note to any associated injuries like head injury, chest injury and fracture limbs. Basic investigations viz. blood Hb, blood urea, blood sugar, serum creatinine and blood grouping were done in all cases. Plain X-ray of the abdomen in erect posture was taken in most of the cases expect in those who were admitted in a critically ill condition. Radiographs of other parts were also taken to find out associated injuries. Under aseptic precaution using sterile 18 G needle peritoneal tapping done in all the four quadrants, in all patients with the history of blunt abdominal trauma. CONCLUSION: 1. The commonest cause of injury in our study is road traffic accidents accounting for 55.5 % of cases which is similar to other studies. Among the road traffic accidents direct hit accounts for 64% of cases followed by run over accidents with accounts for 16 %. 2. Similar to many large series males are more often affected in blunt abdominal injuries than females and middle aged persons are more often affected than extremes of age. 3. It has been shown in our study that the earlier the diagnosis of solid organ injury better is the prognosis. This is consistent with other studies. 4. The commonest intra abdominal organ injured in our study is spleen followed by liver, kidney and pancreas. 5. It has been shown that in cases of fall from height if the height increases there is increased chances of multiple organ involvement. 6. Commonest associated injuries occurred in our study was chest injury in ten cases followed by injury to the extremities in seven cases. 7. Thorough initial clinical evaluation, repeated clinical examinations monitoring vital signs are essential in minimizing the chance of missing life threatening intra abdominal injuries. As with other studies the biochemical investigations are not of much help. The investigations only complimentary to clinical diagnosis.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Blunt Injury Abdomen ; Evolution ; Solid Orgons. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Devi S |
| Date Deposited: | 14 May 2018 15:26 |
| Last Modified: | 14 May 2018 15:26 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7825 |
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