Premium
Abdominal trauma: a disease in evolution
Author(s) -
Smith Jason,
Caldwell Erica,
D’Amours Scott,
Jalaludin Bin,
Sugrue Michael
Publication year - 2005
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2005.03524.x
Subject(s) - medicine , abdominal trauma , abdomen , laparotomy , blunt , blunt trauma , surgery , trauma center , injury severity score , interpersonal violence , penetrating trauma , retrospective cohort study , injury prevention , poison control , emergency medicine
Background: The last decade has seen many changes in the way we investigate and manage abdominal injuries. This study assessed the pattern of abdominal injury and its investigation in patients admitted to a major trauma centre. Methods: A retrospective registry review of all adult trauma patients admitted to Liverpool Hospital between January 1996 and December 2003 was undertaken. All adult trauma patients were included, identifying mechanism of injury, injury severity score, abbreviated injury score for the abdomen, investigations and intervention. The study period was divided (period 1 from 1996 to 1999, period 2 from 2000 to 2003) and the two periods compared to assess change. Results: The study involved 1224 patients with abdominal injuries. Of these, 969 (79%) were a result of blunt trauma. The main causes were road accidents (61%), interpersonal violence (24%) and falls (7%). Penetrating injury increased from 16% to 25% between the two periods. There were 1274 intra‐abdominal injuries, made up of 607 solid organ (liver ( n = 220, 36%), spleen ( n = 195, 32%), renal ( n = 144, 24%) ), 291 hollow viscus (small bowel ( n = 160, 55%), large bowel ( n = 104, 36%) ) and 168 vascular. Four hundred and thirty‐six (36%) patients underwent laparotomy, 65% for blunt trauma. Between the two periods there was a 46% decrease in the use of diagnostic peritoneal lavage, with a 40% increase in computed tomography and 325% increase in focused assessment with sonography for trauma. Conclusions: This study defined abdominal injury pattern and identified a significant shift in mechanism of injury and abdominal investigation at a major trauma centre during an 8‐year study period. Abdominal trauma is indeed a disease in evolution.