International Surgery Journal | January 2017 | Vol 4 | Issue 1 Page 64
International Surgery Journal
Tillu N et al. Int Surg J. 2017 Jan;4(1):64-74
http://www.ijsurgery.com
pISSN 2349-3305 | eISSN 2349-2902
Original Research Article
A study to assess the 30 days outcome of penetrating injuries to the
abdomen
Neeraja Tillu, Chetan Rathod*, Meena Kumar, Vinit Kumar
INTRODUCTION
Trauma is the most frequent cause of death in the first
four decades of life, and it remains a major public health
problem in every country, regardless of the level of
socioeconomic development.
1
The abdomen is the third
most common injured region, with surgery required in
about 25% of civilian cases.
2,3
Penetrating abdominal
trauma typically involves the violation of the abdominal
cavity by a gunshot wound or stab wound. It is on the rise
ABSTRACT
Background: Abdominal trauma is among the leading causes of morbidity and mortality in all age groups in the
world. Many injuries may not manifest during the initial assessment and treatment period. The study was conducted
to determine the different characteristics of the patients with abdominal trauma, to analyse the extent of organ
involvement and to determine the surgical interventions done for the same and to understand the morbidity caused by
various operative procedures, especially due to negative laparotomy.
Methods: A descriptive, prospective, hospital-based study involving observation of patients from admission to final
outcome of management at discharge or death was carried out. Consecutive admissions of 54 patients with abdominal
injuries attended to at the department of surgery, Lokmanya Tilak Medical College, Sion, Mumbai were enrolled in
the study. The study was conducted from September 2013 to September 2015. The data were analyzed using SPSS
software.
Results: 54 patients were enrolled in the study. Male to female ratio was 5.75:1. Mean age was 29.31 years. Majority
of the patients (83.33%) were affected with homicidal stab wounds. The object causing penetrating injury was most
commonly a knife, which was used in 44 patients (81.5%). Thirty patients (55.55%) had isolated penetrating injuries
to the abdomen whereas 24 patients (44.45%) had associated injuries. Amongst the stab wounds, the commonest site
of injury was the umbilical region. The average systolic BP was measured in all the patients. The mean revised
trauma score of all patients was 7.66. The contingency values of patients undergoing chest X-ray, FAST, CT scan and
peritoneal breach v/s patients undergoing exploratory laparotomy were noted. Primary closure of jejunal perforation
(12.5%) and gastric perforation (12.5%) were the most common operative procedures done. Jejunum was the most
frequently damaged organ in most of the patients. The average penetrating abdominal trauma index of the patients
was 6.77. The operative time, time spent on ventilator, days stayed in ICU, length of hospital stay, time taken by the
patients to walk , to sip and to remove mid line suture were noted.
Conclusions: Increased efforts to repair early are likely to reduce the incidence and mortality in patients with
abdominal trauma. Selective non operative management can be practiced in tertiary care centers but its benefits must
be weighed against the risk of missed injuries.
Keywords: Abdominal trauma, Conservative management, Exploratory laparotomy, Morbidity score
Department of General Surgery, Lokmanya Tilak Medical College, Sion, Mumbai, Maharashtra, India
Received: 02 November 2016
Accepted: 05 November 2016
*Correspondence:
Dr. Chetan Rathod,
E-mail: drprasadrathod666@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2349-2902.isj20164053