IJSR - International Journal of Scientific Research

Sreerag S R.; Santhosh Kumar S; Unnikrishnan G

Volume : VII, Issue : IV, April - 2018

An observational study on the incidence mechanism, diagnosis and management of small bowel and mesenteric injuries in blunt abdominal trauma.

Sreerag S R. , Santhosh Kumar S, Unnikrishnan G

Abstract :

Blunt abdominal trauma is a leading cause of morbidity and mortality among all age groups.Identification of serious intra–abdominal pathology is often challenging. Whatever the mechanism, early recognition of these lesions can be difficult. Intestinal disruption can be due to a variety of types of blunt trauma, with automobile being the most common. Diagnostic tools include ultrasonography (US), diagnostic peritoneal lavage (DPL), computed tomography (CT) and diagnostic laparoscopy (DL). Exploratory laparotomy, drainage of septic peritoneal fluid and wound saline lavage are the treatment of choice.

OBJECTIVES

1. The incidence of small bowel and mesenteric injuries in relation to blunt trauma abdomen

2. To evaluate the various diagnostic methods used in diagnosis of small bowel injuries.

3. To undertake a study of the operative procedures and their morbidity in the treatment of small bowel injuries

RESULTS AND CONCLUSION

The majority of cases of blunt abdominal trauma occur in the economically productive age group of 31–40(37.3%).The etiological factor in 68.5% of cases of blunt abdominal trauma was automobile accidents.There was an overwhelming male preponderance of 80% in the victims of blunt abdominal trauma. The time interval between occurrence of the injury and admission to hospital was within 24 hours(over 90%). Incidence of small bowel and mesenteric injuries in blunt abdominal trauma was found to be 41% of cases undergoing laparotomy. Plain x–ray abdomen combined with repeated clinical examination could diagnose the small bowel injury in 80% of cases.

Primary closure of small bowel injury was done in 53.3% of cases whereas resection and end to end anastomosis was done in 26.7% cases.Wound infection occurred in 53.3 % of cases whereas anastomotic leak occurred in 13.3% cases.