Abstract

*Dr. Sabeen Fatima, Dr. Muhammad Daud Ibrahim and Dr. Muhammad Umar

ABSTRACT

Background: To assess the feasibility of Non-operative management of Blunt abdominal trauma in a teaching hospital of Pakistan. Methods: A prospective observational study was carried out over a period of 3 years including 52 cases of blunt abdominal trauma in a teaching hospital in Pakistan. Patient and trauma characteristics of the cases, different modalities of treatment and outcomes were evaluated. All the cases were divided in 3 groups: Operative group, Non-Operative Management and Non-Operative Failure group. Operative group and non-operative management group were compared using Fischer Exact Test for categorical variable and student’s “t” test for continuous variable. Results: There were 36% of cases in operative group, 61% in nonoperative management group and 2% in non-operative management failure group. Non-operative management was successful in 97% of cases. Injury severity score, admission hematocrit and hemodynamic status were significantly different between non-operative management and Operative group. Non-operative management failure occurred in 1 case and was secondary to delayed hepatic hemorrhage. Conclusion: Non-operative management of Blunt abdominal trauma can be attempted with high degree of success. Hemodynamic and clinical instability rather than severity of the organ injury is the predictor of failure in non-operative management. Spleen and bowel injury are the most common organ that usually land up in operative group because of hemodynamic instability in splenic injury and peritoneal contamination in bowel injury. Close surveillance in an intensive care unit is always desirable. causes of preventable trauma-related death. It accounts for 5-15% of all operative abdominal injuries.[1] Blunt trauma is responsible for about 90% of the abdominal injuries.[2] In causes of preventable trauma-related death. It accounts for 5-15% of all operative abdominal injuries.[1] Blunt trauma is responsible for about 90% of the abdominal injuries.[2] In Blunt Abdominal Trauma is one of the most common of improved intensive care, interventional radiology and trauma protocols, it is reported that blunt injuries can now be managed non-operatively with a success rate of almost 85%.[4] Current literature shows that between 50% and 98.5% of patients with blunt hepatic injury receive nonoperative management, and failure rates range from 3% to 15%. Reported success rates for non-operative management of blunt splenic injury are 95% or higher for pediatric patients and approximately 80% or higher in adults.[3] This observational study was carried out in a tertiary care teaching hospital of a developing nation to assess the feasibility of non-operative management of Blunt abdominal trauma.