www.ijcmr.com International Journal of Contemporary Medical Research ISSN (Online): 2393-915X; (Print): 2454-7379 | ICV: 77.83 | Volume 5 | Issue 1 | January 2018 5 Section: Surgery Study of Clinical Profle and Management of Blunt Abdominal Trauma Girish M Umare 1 , Nitin Sherkar 1 , A Motewar 2 ORIGINAL RESEARCH ABSTRACT Introduction: In today’s mechanized world Blunt Abdominal Trauma (BAT) is a common emergency which is associated with considerable morbidity and mortality. More than 75% of abdominal traumas are blunt in nature and liver and spleen are the commonest organs to be injured as a result of BAT. This study was conducted to evaluate cases of BAT with special emphasis on study of associated epidemiological factors, clinical profle and management strategies in patients presenting BAT. Material and Methods: We conducted this prospective study of 50 patients admitted to our institute with history of Blunt Abdominal Trauma. After appropriate resuscitative measures detailed history was taken followed by thorough clinical examination in all the patients. Demographic data, history, clinical and intraoperative fndings, investigations and complications during hospital stay and during follow up visits were all recorded.The management was decided depending upon history, clinical examination and investigations. Results: Males were predominantly affected and most cases were between the age group of 11-40 years (76%). Majority of the patients (88%) presented with the complaint of abdominal pain followed by abdominal guarding (72%) and abdominal distension (52%). 29 (58%) patients were managed conservatively while operative interventions were required in 21 (42%) patients. Common surgeries performed in the studied cases included splenectomy (28.57%), primary closure of perforation (23.80%) and resection and anastomosis (19.04%). Majority of the patients (78%) were discharges within 10 days of admission. Conclusion: Blunt Abdominal Trauma is one of the important causes of morbidity and mortality in young adults. Immediate resuscitative measures, management of associated injuries and appropriate operative intervention are important parts of management of such cases. Keywords: Blunt Abdominal Trauma, Imaging studies, Visceral Injuries, Operative Interventions. INTRODUCTION With modernization, industrialization and motorization of the society there is a rapid increase in the incidence of Blunt Abdominal trauma (BAT). It is one of the most common injuries amongst those caused due to road traffc accidents 1 . Injuries are reported to be amongst the top 10 killers around the world and abdominal injuries are amongst the top 3 of these overall cases. Majority of these abdominal injuries (> 80%) are of blunt character. Spleen and liver are found to be injured in majority of cases of BAT. Other injuries which may be seen include renal injuries, injuries to urinary bladder and urethra, pelvic fractures and vascular injuries. Motor vehicle accidents account for 75 to 80% of blunt abdominal trauma 2 . Blunt injury of abdomen can also occur as a result of fall from height, assault with blunt objects, industrial mishaps, sport injuries, bomb blast and fall from riding bicycle 3 . Blunt abdominal trauma is usually not obvious hence, often missed, unless, repeatedly looked for. Delay in diagnosis and inadequate treatment of the abdominal injuries may prove fatal. The status and co-existing injuries which may distract the attending surgeon from properly assessing diffculty in diagnosis arises from the factors like delay in reaching hospital, altered mental status of the patient and co-existing injuries making the diagnosis diffcult 4 . The factors like altered mental status of the patiens makes it necessary that the management should not be based entirely on the basis of clinical examination and rather should be assisted by imaging like FAST (Focused assessment of sonography in trauma) and computed tomography (CT) 5 . The management needs multidisciplinary approach. In spite of the best techniques and advances in diagnostic and supportive care, the morbidity and mortality remains at large 6 . The usual complication arising out of BAT includes hemorrhagic shock due to blood loss. Fluid resuscitation and non operative management is all that is needed in haemodynamically stable patients with BAT. But in some cases refractory shock not responding to aggressive fuid resuscitation may be seen. In such patients one of the main concerns from the point of view of a treating surgeon is control of bleeding 7 . Continued intraabdominal bleeding secondary to vascular injuries may be the cause of patient not responding to fuid resuscitation and in such patients surgical interventions like therapeutic laparotomy ad appropriate measures to stop bleeding (ligation of bleeders) may prove life saving 8 . The other indications for surgical interventions may include extensive renal injuries, expanding hematoma and extensive splenic injuries 9 . The major causes of mortality in cases of BAT include delay in seeking treatment, poor general condition and associated injuries (Head injury, lung laceration and 1 Assistant Professor, Department of Surgery, Government Medical College, Nagpur, 2 Associate Professor, Department of Surgery, Dr Shankar Rao Chavan Government Medical College, Nanded, India Corresponding author: Dr Girish M Umare, 104, Shri Siddhesh Sai Leela Apartment, Old Subhedar Layout, Sharda Chowk, Manewada Road, Nagpur (MS) 440024, India How to cite this article: Girish M Umare, Nitin Sherkar, A Motewar. Study of clinical profle and management of blunt abdominal trauma. International Journal of Contemporary Medical Research 2018;5(1):5-9.