Publication:

Prospective observational study of blunt abdominal trauma and hemoperitoneum

Background The early recognition and appropriate management of solid organ injuries in blunt abdominal trauma are pivotal in improving patient outcomes. The aim of this study was to evaluate the factors affecting outcome of solid organ injury with blunt abdominal trauma and hemoperitoneum.

Methods A prospective observational study was conducted over a period of two years at a tertiary care centre providing advanced trauma and emergency surgical services in Western Maharashtra. A total of 44 patients presenting with blunt abdominal trauma and radiological or clinical evidence of solid organ injury with hemoperitoneum were included. Demographic characteristics, mechanism of injury, clinical presentation, imaging findings, associated injuries, management strategies, and outcomes were analysed.

Results Among the 44 patients, the majority (38.6%) were aged 16–30 years, and males constituted 84.1% of the cohort. Road traffic accidents were the most common cause of injury (61.4%). Associated injuries were present in 38.6% of patients. Computed tomography revealed mild intraperitoneal fluid collection in 22.7% of cases. Only 6.8% of patients required operative management, with intraoperative findings showing liver injury in two patients and splenic injury in one patient. The overall mortality rate was 4.5%. Younger age and associated head injury were significantly associated with mortality. Clinical shock at presentation significantly influenced the management approach.

Conclusion Blunt abdominal trauma with solid organ injury predominantly affects young males and is most commonly caused by road traffic accidents. Mortality is mainly associated with high-grade splenic injury and concomitant head injury. Continuous monitoring of haemoglobin levels and clinical signs of shock is essential for guiding management and predicting outcomes rather than relying solely on the patient’s condition at admissions.