Blunt hollow viscus and mesenteric injury (HVMI) is not only an uncommon finding but its timely diagnosis is also difficult. Blunt abdominal trauma is the leading cause of intra-abdominal injury with motor vehicle accidents being the leading cause of blunt abdominal trauma [ 1 ]. Penetrating. The incidence of TDH in trauma patients is around 0.8%-5% and occurs more commonly in males than females [, , ].TDH occurs mostly in blunt trauma, and less frequently in penetrating injuries (13.3-55%) [5,6] and was described in rare cases of iatrogenic trauma as . The most common cause is a stab or gunshot. Blow to the stomach (like a punch) 4. An inside view of trauma. Complications may include blood loss and infection.. Complications after abdominal trauma. Blunt force trauma occurs when a strong force hits the body (in this case, the abdomen), but does not penetrate the skin. Epidemiology of renal trauma: In blunt abdominal trauma, up to 40% present with renal injury. What are examples of blunt trauma? Missed splenic injury is the most common cause of preventable death after blunt abdominal trauma. Duodenal injury Penetrating trauma, predominantly GSW 75% & blunt 25% The second portion of the duodenum is most commonly injured Delays in diagnosis in case of isolated injury. Removal of the spleen is associated with a number of complications including bacterial infections, deep vein thrombosis, pulmonary embolism and . Abdominal trauma remains a leading cause of mortality in all age groups. Being hit by the handle bars of a bike. These are: Blunt Trauma: This is a direct blow to the stomach that does not break the surface . Background Intestinal disruption following blunt abdominal trauma (BAT) continues to be associated with significant morbidity and mortality despite the advances in . Abstract. Aims and objectives The aim of this study is to determine the causes, pattern, management . The mortality . The commonest organ . Complications of blunt abdominal trauma include peritonitis, haemorrhagic shock, and death. 3 It is therefore important to have a high index of suspicion for this diagnosis when evaluating patients with blunt trauma. BLUNT ABDOMINAL TRAUMA BY: ANNE E. ODARO (MCM/2017/69852) FACILITATOR: DR. NYAGA. In children (less than or equal to 14 years of age), blunt abdominal trauma is the second most frequent cause of mortality preceded by head injuries. Solid and hollow organ injuries may occur in abdominal trauma patients. This force can be an object such as a baseball bat, kick, steering wheel . 1. Splenic Trauma. Whether prolonged extrication was required. Patients Two hundred eighty patients were admitted to the adult trauma service with blunt splenic injury during a 4-year period. Blunt abdominal trauma due to road side accident was the leading cause of abdominal trauma 9 (9%) followed by traumatic perforation due to stab 5 (5%) (Table 1). Recognition of this fundamental role in the immune response during the last century has led to greater . Diagnosis may involve ultrasonography, computed tomography, and peritoneal lavage, and treatment may involve surgery. It has greater mortality than penetrating as there is often injury to multiple organ systems. The purpose of this study was to determine if nonoperative treatment of blunt liver and splenic injuries has any long-term consequences that may be detrimental to patients. Source publication Progressing Aspects in Pediatrics and Neonatology 10-Year Analysis of Pediatric Blunt Abdominal Trauma: Accident Mechanisms and Prevention main role in abdominal trauma is stop bleeding without the physiological stress of surgery. Motor vehicle crashes are the most common cause of blunt trauma in . When the injury is close range, there is more kinetic energy than those injuries sustained from a distance. Penetrating abdominal trauma is seen in many countries. Few guidelines exist at present to aid the surgeon in deciding which injuries r Setting University teaching hospital, level I trauma center.. Blunt trauma injuries to the pancreas are rare but are associated with significant overall mortality and a high complication rate. Complications of blunt abdominal traumaBlunt abdominal trauma can cause damage to the internal organs, resulting in internal bleeding, cause contusions, or injuries to the bowel, spleen, liver, and intestines. postoperative complications, and associated trauma especially to spine, head, thorax, and extremities. Identification of serious intra-abdominal pathology is often challenging. With blunt trauma, splenic lacerations are the most common injury followed by liver lacerations. 3. 2 Compared with patients in whom injury is promptly recognized, those with delay in diagnosis of splenic trauma have a ten-fold increase in mortality. 21 All have been rarely described, but the very high and increasing incidence 22 of falls among the elderly and the frequent failure of physicians to consider the . Abdominal trauma remains a leading cause of mortality in all age groups. Complications of blunt abdominal trauma include peritonitis, hemorrhagic shock, and death. The spleen is the most commonly injured organ in blunt abdominal trauma. Aneurysms are a less common complication of blunt head trauma, but can occur in rare instances and prove to be fatal. September 25, 2020 TheTraumaPro Leave a comment. Trauma is the leading cause of nonobstetric death in expectant mothers, affecting 7 percent of all pregnancies; most often trauma occurs in the third trimester. Due to its less frequency, this injury has not been studied in detail prospectively. A bucket-handle injury is a relatively uncommon complication of blunt trauma to the abdomen. Other notable complications of blunt abdominal trauma during falls in elderly patients include aortic dissection, 19 atheroembolic disease 20 and even small-intestinal perforation. Blunt trauma may involve a direct blow (eg, kick), impact with an object (eg, fall on bicycle handlebars), or sudden deceleration (eg, fall from a height, vehicle crash). 2. Physical examinations signs following blunt abdominal trauma should raise suspicion of a severe injury when the following are present: seatbelt injury, rebound tenderness, hypotension BP<90, . See text for details. Blunt abdominal trauma commonly results from either a compression force or a deceleration injury. For this reason, abdominal trauma can lead to substantial medical problems. The following diagnostic methods are used to evaluate and classify abdominal trauma: Ultrasound is a common tool in EDs because it's portable, noninvasive, and can be used during resuscitation.Focused abdominal sonography for trauma (FAST) is close to 100% specific and 98% accurate in evaluating blunt abdominal trauma. Common injuries are divided into two categories: solid organ (e.g., liver, spleen, pancreas, kidneys) and hollow organ (e.g., stomach, large and small bowel, gall bladder, urinary . He had a history of blunt abdominal trauma 13 years ago with recurrent symptoms of bowel obstruction resolving spontaneously. Behind the small intestine; includes the kidneys, ureters, and bladder. Blunt abdominal trauma is a leading cause of morbidity and mortality among all age groups. Whether a passenger died. Abdominal trauma is an injury to the abdomen.Signs and symptoms include abdominal pain, tenderness, rigidity, and bruising of the external abdomen. Important factors relevant to the care of a patient with blunt abdominal trauma, specifically those involving motor vehicles, include the following: The extent of vehicular damage. . Intestinal injuries, although less common, may also be present. Definition. Background: Blunt abdominal trauma is a leading cause of morbidity and mortality among all age groups. There are a number of classical injury patterns, which occur following common mechanisms of injury such as rapid deceleration while wearing a lap-only . The spleen is the organ damaged most commonly, followed by the liver and a hollow . The difference in severity between presenting symptoms and actual injuries in a significant number . A retrospective review was conducted of 112 adult trauma patients that were treated nonoperatively for blunt abdominal trauma between 1991 and 1998. Symptoms depend on the type of trauma and what body part was involved. DISCUSSION. In ski resorts, 2/3 of renal injuries are due to skiing accidents. . Sepsis and multiple organ failure . Common injuries are divided into two categories: solid organ (e.g., liver, spleen, pancreas, kidneys) and hollow organ (e.g., stomach, large and small bowel, gallbladder, urinary . Identification of serious intra-abdominal pathology is often challenging; many injuries may not manifest during the initial assessment and treatment period. MVA. Thirteen percent of blunt abdominal trauma patients suffer intra-abdominal injuries with 4.7% requiring intervention [ 2 ]. In urban areas, 80% of renal injuries occur in the context of polytrauma. The rapid increase in motor vehicles and its aftermath has caused rapid increase in the number of victims to blunt abdominal trauma (BAT). Oct. 06, 2017. Unstable patients undergo laparotomy and splenectomy. Blunt trauma, also known as non . Patients can also present with extra-abdominal injuries such. This study aimed to retrospectively assess the rate of splenic salvage and complications after SAE for blunt trauma at a level 1 trauma center using the 2018 update to the AAST criteria, and further . 1. As an adjunct to non-operative management, splenic artery embolization (SAE) has been increasingly utilized throughout the world and is now the standard of care for hemodynamically stable patients. Bladder rupture can also be encountered. Abdominal trauma is divided into: Penetrating abdominal trauma (PAT), usually diagnosed based on clinical signs. Abdominal trauma is typically also categorized by mechanism of injury: Blunt. If a pregnant person suffers a traumatic injury during pregnancy, there is a risk of miscarriage depending on the stage of pregnancy and severity of the trauma. Radiologic Procedure Rating Comments RRL* X-ray abdomen supine and upright 8 CT and x-rays may be appropriate. It receives 5% of the cardiac output, accounts for 25% of the total reticuloendothelial cell mass, and plays a major role in clearing the plasma antigens. Traditional managem splenic hematomas has been primarily surgical. There were 3 deaths among the 47 patients. 3, 6 Physiologic changes include a 30% to 50% increase in blood volume and a . Injuries Seen in Abdominal Trauma - Differential Diagnosis. Complication rates after the operative treatment of pancreatic injuries range from 26% to 86%. Blunt abdominal trauma in cases of multiple trauma evaluated by ultrasonography: a pros pective analysis of 291 patients.J Trauma 32: 452-458: II: . Blunt abdominal trauma is more likely to be delayed or altogether missed because . Blunt abdominal trauma + hypotension with positive FAST scan, positive diagnostic peritoneal lavage (DPL) or peritonism. Motor vehicle accidents account for 75%-80% of BAT. Major trauma has been associated with 7 percent of maternal and 80 percent of fetal mortality. Methods: This study was conducted on 50 patients of blunt abdominal trauma . Injuries to the intestine and mesentery are often found in patients undergoing laparotomy for blunt abdominal trauma. Right kidney injury with blood in perirenal space. Out of 100 laparotomy cases performed, post-operative complications were found in 68 patients. Cases of blunt abdominal injury (N = 927) to children ages 0 to 4 years were extracted from the National Pediatric Trauma Registry. . Blunt abdominal trauma can result in multiple different organ injuries. Post-operative fever (68%), nausea and vomiting (56%) were the common complications. This injury is extremely rare (<0.5% of abdominal trauma), all cases were initially missed, and diagnosis on average was delayed 19 days. Method: We retrospectively reviewed all adult patients with intestinal injuries . Patients can also present with extra-abdominal injuries such. Traumatic diaphragmatic hernia (TDH) or rupture is a serious complication of abdominal or thoracic trauma. In patients with blunt abdominal trauma, injuries to solid organs predominate, with splenic and liver injury being commonest, while trauma to the pancreas is uncommon with a reported incidence of 0.4% to 12%. A 38-year-old male who sustained blunt abdominal trauma at work presented to the emergency department with complaints of abdominal pain localized prim The spleen is the most commonly injured organ in blunt abdominal trauma. It is thought that the fixed portions of the small bowel, namely, the terminal ileum and proximal jejunum, are prone to perforation during blunt . Even though most gunshot wounds typically have a linear . Advances in Abdominal . [2] BAT makes up 75% of all blunt trauma and . The authors examined the incidence and characteristics of traumatic testicular dislocation in patients who had sustained blunt abdominal trauma. It can detect 100 ml or more of fluid or blood in . Patients can also present with extra-abdominal injuries such. Blunt abdominal injury (BAI) is common and usually results from motor vehicle collisions (MVC), falls and assaults. These . Introduction. Measures included hospital utilization (days hospitalized, intensive care unit use, and surgery) and patient outcome (in-hospital fatality, discharge to rehabilitation facility, home rehabilitation, and home . Complications of blunt abdominal traumaBlunt abdominal trauma can cause damage to the internal organs, resulting in internal bleeding, cause contusions, or injuries to the bowel, spleen, liver, and intestines. Anatomic and physiologic changes of pregnancy influence the assessment, management, and prevention of trauma. Stable patients with lower grade injuries are treated conservatively; those stable patients with moderate to severe splenic injuries (grade III-V) benefit from endovascular splenic artery embolization. What this study adds to our knowledge. Blunt abdominal trauma (BAT) mainly results from motor vehicle accident, fall from height and assaults. Splenic hematoma is a known complication of blunt force abdominal trauma. It is divided into two types blunt or penetrating and may involve damage to . ACR Appropriateness Criteria 1 Blunt Abdominal Trauma American College of Radiology ACR Appropriateness Criteria Clinical Condition: Blunt Abdominal Trauma Variant 1: Stable patient. Explain the management and rehabilitation strategies for patients with blunt abdominal trauma. It only occurs in a few percent of patients, but is much more likely if they have a seat belt sign. Complications in evaluating abdominal trauma: diagnostic peritoneal lavage versus computerized axial tomography.J Trauma 30: 1506-1509: III: