A characteristic of hollow viscus injury (HVI) following blunt abdominal trauma: a study done in Vandana Nursing Home and IVF Clinic, Hazaribag, Jharkhand, India

Surgical Update: International Journal of Surgery and Orthopedics Pub Date : 2020-01-27 DOI:10.17511/IJOSO.2020.I01.04

Abhishek Kumar, S. Snehlata

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Abstract

Objective: To determine the presentation, anatomical distribution, diagnostic method, management and outcome of hollow viscus injury (HVI) from blunt abdominal trauma. Methods: This was a retrospective cross-sectional study including patients with blunt abdominal trauma leading to HVI admitted at Vandana Nursing Home and IVF Clinic, Hazaribag. A prospective comparison study over a period of 6 years (April 2012 to May 2018). Data were retrieved from patients’ medical records. Total 43 patients with HVI due to blunt abdominal trauma, who underwent laparotomy at our institute, were reviewed. Data regarding clinical presentation, anatomical distribution, management and outcome were recorded and analysed. Results: Out of 43 patients 87.1% were men and 12.9% were women. Mean age of patients was 29±14.02 years. The most common site of injury was ileum (46.2%) followed by jejunum (44.5%). There were 2 gastric perforations (4.6%), 1 (2.3%) duodenal, 1 (2.3%) colonic, 1 (2.3%) sigmoidal and 1 (2.3%) rectal injuries. One caecal injuries was also recorded. Road traffic accident was the most common mechanism of injury (57.2%) followed by fall from height (36.4%) and assault (6.4%). Free gas under diaphragm on erect abdomen radiography was seen in 85.5% of cases while preoperative CT Abdomen was done in 11.6% of cases. Treatment consisted of simple closure of the perforation (66.5%), resection and anastomosis (11.0%) and stoma (22.5%). Major complication was anastamotic leak which was recorded in 6.4% cases and 15.6% patients developed burst abdomen. Average hospital stay was 13±6 days. Overall mortality rate was 12.7%. Conclusion: Although early recognition of intestinal injuries from blunt abdominal trauma may be difficult in all cases, it is very important due to its tremendous life-threatening potential. Age of the patient, anatomical site and time of presentation are probably main prognostic factors

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钝性腹部创伤后空心内脏损伤(HVI)的特征:在印度贾坎德邦Hazaribag的Vandana养老院和试管婴儿诊所进行的一项研究

目的:探讨钝性腹部外伤致空心内脏损伤的表现、解剖分布、诊断方法、处理方法及预后。方法:这是一项回顾性横断面研究，包括在Vandana养老院和Hazaribag试管婴儿诊所入院的钝性腹部创伤导致HVI的患者。一项为期6年(2012年4月至2018年5月)的前瞻性比较研究。数据从患者的医疗记录中检索。我们回顾了43例因钝性腹部创伤而接受剖腹手术的HVI患者。记录和分析临床表现、解剖分布、处理和结果等数据。结果:43例患者中男性占87.1%，女性占12.9%。患者平均年龄29±14.02岁。最常见的损伤部位是回肠(46.2%)，其次是空肠(44.5%)。胃穿孔2例(4.6%)，十二指肠穿孔1例(2.3%)，结肠穿孔1例(2.3%)，乙状结肠穿孔1例(2.3%)，直肠穿孔1例(2.3%)。盲肠损伤1例。道路交通事故是最常见的伤害机制(57.2%)，其次是高空坠落(36.4%)和殴打(6.4%)。腹直片膈下游离气体占85.5%，术前腹部CT占11.6%。治疗方法为单纯缝合穿孔(66.5%)、切除吻合(11.0%)、造口(22.5%)。术后主要并发症为吻合口漏，发生率为6.4%，腹部爆裂率为15.6%。平均住院时间13±6天。总死亡率为12.7%。结论:钝性腹部外伤引起的肠道损伤虽然在所有病例中都很难早期识别，但由于其具有巨大的生命危险，因此非常重要。患者的年龄、解剖部位和发病时间可能是影响预后的主要因素

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Surgical Update: International Journal of Surgery and Orthopedics

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