Hollow Viscus Injury Following Blunt Abdominal Trauma: A Retrospective Study

ABSTRACT

Background: Gastrointestinal and mesenteric injuries are the third most common type of injury from blunt trauma abdomen and are associated with high rates of morbidity and mortality.Objectives: To determine the clinico-demographic profile, localization of injury, diagnostic and management methods and the outcome in cases of hollow viscus injury (HVI) following blunt trauma abdomen which were admitted to our unit. Methods: Records of patients who were admitted emergently with gastrointestinal injuries and blunt abdominal trauma between July 2014 and July 2016 were reviewed retrospectively. Results: The study group comprised 65 patients with mean age of 33.3 ± 16.2 years and a male predominance (89.2%). The commonest cause of injury was road traffic accident in 44 (67.7%) cases. Ileum was the most common site of injury detected in 31 (41.3%) followed by jejunum in 26 (34.7%) cases. Treatment comprised primary closure of perforation in 48 (64%) cases, segmental resection and anastomosis in 22 (29.3%), and stoma in 5 (6.7%) cases. Three out of 5 cases of anastomotic leak occurred in patients who were operated at 8-24 hours or beyond. Associated injury to intra-abdominal solid viscera and other sites were present in 30.7%. The mean duration of hospitalization was longer in patients with associated injuries as compared to those with isolated HVI (12.2±4.6 days versus 9.3±0.8 days). Conclusion: Early diagnosis followed by prompt surgical intervention and careful monitoring for associated injuries is the key to favourable outcome in blunt HVI.