Pattern of visceral injuries following blunt abdominal trauma in motor vehicular accidents

Abstract

Objective: To determine the frequency of various visceral injuries following, high-speed motor vehicle crashes with special reference to frequency of liver injuries, severity and complications.

Design: A descriptive study.

Place and duration of study: Surgical Unit III, Jinnah Hospital, Lahore, from August 1999 to February 2002.

Patients and methods: The study included 100 consecutive patients of blunt abdominal trauma. Patients of either gender and age above 12 and below 70 were included in this study. Purposive non-probability sampling was done. Injuries were identified, graded and managed accordingly. The data was then entered into SPSS and descriptive statistical tests were applied.

Results: Liver was the most common organ injured (35%), followed by spleen (32 %) and small gut (30 %). In 23 patients, liver was the only organ injured. Most of the liver injuries fell under grade I (42.8%) followed by grade II (28.35%) and grade III (22.85%) and were treated by suture hepatorrhaphy alone in 71.42% cases. The operated cases were mostly complicated by wound infection (33.76%). Overall mortality remained high (12%) and was related to a combination of delays in arriving at a diagnosis due to non-availability of CT scan and routine use of peritoneal lavage.

Conclusion: Liver is the most commonly affected organ in high speed motor vehicle crashes that is reliably treated by suture hepatorrhaphy. The rate of postoperative infection and morbidity is high.