Title: Prospective Study of Penetrating Abdominal Injuries
Author: Nagar, R. C., Garg Ganga Shankar, Chittora S. P
DOI: http://dx.doi.org/10.18535/jmscr/v4i7.79
Background: The incidence of penetrating abdominal injuries is increasing in modern civilian era. Objective: To determine the types of penetrating abdominal injuries & outcome of management. Method: Relevant details of patients treated with penetrating abdominal injuries were recorded 7 analysed. Result: there were 25 patients of PAI, mostly male. Male & female ratio was 21:4. The age ranged from 8 years to 60 years. The peak age of patients was third & second decade. Causes of various penetrating injuries were – Stab wounds- 15 (60%), GSW-3 (12%), Cow horn injury-2 (8%), RTA-1 (4%), Glass injury- 1 (4%), Cracker explosion- 1 (4%), Blast injury-1 (4%) & Unknown (stick)- 1 (4%). Three patients were managed conservatively. 22 patients had laparotomies. Various organ injuries observed in 25 patients were: Stomach-7 (28%), Mesentery-7 (28%), Small intestines- 6 (24%), Liver- 5 (20%), Colon-3 (12%) & Abdominal wall-2 (8%). Rare injuries were: Gall bladder-1 (4%), Spleen- 1 (4%) & Diaphragm- 1 (4%). Evisceration of intestines in 5 patients (20% )& Evisceration of Omentum in 4 patients (16%). Conclusion: Stab wounds are main cause of PAI; mostly young males are injured. Laparotomy is safe & good method of treatment. Selective patients may be managed conservatively. Mortality rate was 4% overall & 4.54% in operative group. Keywords: Penetrating Abdominal Injuries, Gun Shot Wound, Road Traffic Accident, Laparotomy & Anastomosis, Evisceration, Stab wounds, Non-Operative management. 1. Lee WC, Uddo JF and Nance FC,” Surgical judgement in the management of abdominal stab wounds : utilizing clinical criteria from a 10- years experience”, Ann. Surg., vol. 199. No. 5 : 549-553, 1984 2. Musau P, Jani PG and Owillah FA,” Pattern and outcome of abdominal injuries at Kenyatta National Hospital, Nairobi”; East African Medical Journal , Vol. 83 No.1:37-43, 2006 3. Ohene- Yeboah, Dakubo JCB, Boakye F and Naeeder SB,” Penetrating abdominal injuries in adults seen at two teaching hospitals in Ghana”, Ghana Medical Journal, Vol 44, No. 3 : page 103-108, 2010 4. Deodhar SD, Patel NP, Shah KB and Jammihal HJ,” Blunt and penetrating abdominal injuries ( a study of 51 cases )”, Journal of Postgraduate Medicine , Volume 29.Issue 2, Page:96-98, 1983 5. Butt MU, Zacharias N and Velmahos GC,” Penetrating abdominal injuries : Management controversies” , Scandinavian J. of Trauma: Resuscitation and Emergency Medicine,17:19, 2009 http://www.sjtrem.com/content/17.1.19 6. Shaftan GW,” Indications for operation in abdominal trauma”, Ann. J. Surg., 99: 657-664, 1960 7. Nance FC, CohnIJr,” Surgical judgement in the management of stab wounds of the abdomen : a retrospective and prospective analysis based on a study of 600 stabbed patients”, Ann. Surg ; 170: 569-580, 1969 8. Nance FC, Wennar MH, Johnson LW,et al.” Surgical judgement in the management of penetrating wounds of the abdomen : experience with 2212 patients”, Ann. J. Surg 179 : 639-646, 1974 9. NavsariaPh, Berli JU, Edu S and Nicol AJ: “Non-operative management of abdominal stab wounds- an analysis of 186 patients”, SAfr J Surg , 45 : 128-132, 2007 10. Leppaniemi AK, Haaipian RK,” Selective non-operative management of abdominal stab wounds : prospective randomized study”, World J Surg, 20: 1101-1105, 1996 11. McFarlane, M.” Management of penetrating abdominal injuries”, W. Indian Med. J., 144:140-142, 1995 12. Chmielenski, G. W., Nicholas, J. M., Duchavsky, S. A, et al.” Non-operative management of gunshot wounds of the abdomen”. Amer. Surg. 61: 665-668, 1995 13. Sosa, J. C., Arrigalla, A., Puente, I., et al.” Laparoscopy in 121 consecutive patients with abdominal gunshot wounds”, J. Trauma-Injury Inf. Crit. C., 39: 501-504, 1995 14. Renz BM, Feliciano DV, “Unnecessary laparotomies for trauma: a prospective study of morbidity”. J. Trauma, 38: 350-356, 1995Abstract
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