Abdominal trauma can either be penetrating or blunt. Gunshot and stab are examples of penetration abdominal trauma whereas common causes of blunt injury includes vehicle crashes, physical assault  and fall from height with increasing activities associated with modernization and industrialization in developing countries trauma has become an issue. Nevertheless, trauma is the sixth case of morbidity and mortality worldwide and death from trauma is preventable. Head injury and long bone injury are mostly seen at trauma, then comes the abdomen in terms of hierarchy. Even hitherto unnoticed trauma to the abdomen can lead to deadly intra-abdominal bleeding especially if there is preventing underlying pathology. 

It is estimated that 25% of all abdominal trauma requires abdominal exploration. Because of the danger related with inadvertently missing abdominal trauma injury, frequent evaluation and assessment with the involvement of imaging such as focused assessment with sonography in trauma (FAST) and contrast-enhanced computed tomography of the abdomen is advised. FAST and CECT can detect free fluid inside the peritoneum and pericardium and also injuries in the chest and abdomen. 

Solid injuries to the spleen, liver and kidney with the attendant hemo peritoneum could present with signs of hemorrhagic shock and enteric injuries to the gut can become septic setting up inflammatory reactions in the abdomen.

This study is prospective and analytical in nature. We were privileged to conduct this study in a 76 bedded UNIMEDTH trauma centre between June 2019 to June 2021. 101 patients who had blunt trauma to the abdomen were recruited for the study after excluding the following:

• Polytrauma cases involving other regions of the body

Figure 1: Male:Female Ratios in Blunt Injury  to the Abdomen

Table 1: Age Distribution in Blunt Abdominal Trauma

Figure 2: Age Distribution in Blunt injury to the Abdomen

Table 2: Mechanism of Injury

Table 3: Imaging Protocol

Table 4: Estimate of Selective Non-Operative Management vs. Direct Exploratory Laparotomy

Table 5: Time of Presentation-Time from Incident to Hospitalization

Table 6: Symptoms/Signs

• Patients having both blunt and penetrating injuries 

• Patients who were dead before initial medical attention

• Those cases that were referred to other hospitals 

• Data analysis was by SPSS version 23 (IBM incorporated Chicago USA).Of the 101 patients 

Figure 3: Showing Complications in the Management of Patients with Blunt Abdominal Injuries

with blunt abdominal trauma, there were 80 males and 21 females. Male: female ratio = 4:1

Procedures Done At Laparotomy on Injuries to Solid Organ, GIT, Diaphragm and Mesentery

• Splenectomy

• Repair procedures omental patch/primary closure 

• Resection and anastomosis 

• Diversion (iliostomy/colostomy)       

Complications Encountered in the Management of Patients with Blunt Abdominal Injuries

• Wound infection: 12%

• Pneumonia:                  8%

• U.T.I:              6%

• Sepsis:           3%

• Burst abdomen:         2%

• Hypovolaemic shock:              2%

• AROS:             1%

• DVT:               5%

Our work in this trauma centre analysis shows the pattern of intrabdominal injuries and its democracy and management. Males were mostly involved with blunt abdominal injuries in keeping with similar reports elsewhere [1]. The commonest age group of affected persons was 21-30 years (40%) and its relates similarly to studies done by Gad M.A. et al. [2-6].

Because of urbanization and associated increase in human traffic road traffic accident as depicted in our study is the commonest mechanism of injury for blunt abdominal trauma [7]. 

Our study also shows that the spleen was the most commonly injured abdominal organ. This finding was similar to most other studies. However some studies showed that the liver was the most commonly injured in blunt abdominal trauma. 

Comparatively hollow visceral injury has higher incidence of laparotomy as a result of increased failure rate of selective no operative management (92%) as compared to the Spleen and liver 11 % and 6% respectively.

Wound infection was found to be the most common complication and this was in keeping with the work done by Rajkumar P.N. et al.  Overall we lost 5 patients and all died from septicemia shock.

Our study indicated that males in their very young active life suffered mostly from blunt abdominal trauma. There is no doubting the fact that a well-structured trauma center is a sine qua non for effective management of blunt abdominal injury. 

Trauma care for patients with blunt abdominal injury will require intensive care, ATLS protocol and ancillary imaging techniques inclusive of adequate clinical and monitoring devices and. All these will increase non-operative management and reduce operative management with inherent morbidity and mortality.

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3. Gad, M.A. et al. "Incidence patterns and factors predicting mortality of abdominal injuries in trauma patients." Am J Med Sci., vol. 4, no. 3, 2012, pp. 129–13 4.

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7. Mehta, N. et al. "An experience with blunt abdominal trauma: evaluation, management and outcome." Clin Pract., vol. 4, no. 2, 2014, p. 599.