Volume : VIII, Issue : III, March - 2018

Non-operative Management of Selected Abdominal Trauma patients- A Prospective Study

Dr Khalid Muqueem, Dr Maktum Naik

Abstract :

 

Contrast Enhanced Computerised Tomography (CECT) scan is considered to be a very important investigative technique for deciding patients, whether to manage conservatively i.e. non–operatively, in patients with abdominal trauma. But, CECT has its own risks and hazards. We undertook a prospective study to evaluate the safety and efficacy of non–operative management (NOM) in selected patients with abdominal trauma without a protocol of mandatory CECT scan of abdomen.

Exclusion criteria were, patients with peritonitis and those with active intra–abdominal bleed.

Inclusion criteria were, patients with FAST (Focussed Abdominal Sonography in Trauma) positive, hemodynamically stable with blunt or penetrating trauma abdomen between age of 18 years to 60 years. Initially forty–two patients were included in the study, but inclusion criteria could not be satisfied in eleven patients. Another 9 patients were also removed from the list because they required immediate emergency laparotomy. Thus only twenty–two  patients could fulfil both inclusion and exclusion criteria in the study period, which were included in the NOM study.

Mean age of these patients was 29 years. 18 (81.8%) of these patients were male. Seventeen patients (77.3%) had sustained blunt trauma (Road Traffic Accidents– 12 and Fall from height–5). Five patients (22.7%) presented with penetrating trauma.

NOM without CECT was successfully done in 17 (77.3%) patients. Whereas in 4 (18.2%) patients, emergency laparotomy was later performed, based on clinical judgement and ultrasonographic evidence. In one patient (4.5%), we had to do a CECT, because of deteriorating condition.

Thus  21 out of 22 patients (95.5%) selected for study could be managed without exposing them to unnecessary CECT scan, thus significantly reducing the cost and radiation exposure to the patient.

Selected cases of abdominal trauma could be managed by Non operative management without even doing CECT scan.

Keywords :

Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Dr Khalid Muqueem, Dr Maktum Naik, Non-operative Management of Selected Abdominal Trauma patients- A Prospective Study, INDIAN JOURNAL OF APPLIED RESEARCH : Volume-8 | Issue-3 | March-2018

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