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. 2021 Jan 27:38:89.
doi: 10.11604/pamj.2021.38.89.20061. eCollection 2021.

Blunt trauma to abdominal solid organs: an experience of non-operative management at a rural hospital in Zambia

Sergiy Karachentsev  1
Affiliations

Blunt trauma to abdominal solid organs: an experience of non-operative management at a rural hospital in Zambia

Sergiy Karachentsev. Pan Afr Med J. .

Abstract

Introduction: although non-operative management of patients with blunt trauma to abdominal solid organs has become standard care, the role of peripheral hospitals remains poorly defined. This study reviews treatment and outcomes in patients with liver and spleen injuries at a regional hospital over a 10-year period.

Methods: a retrospective review of prospectively collected data was performed and supplemented by case notes retrieval. All patients with solid visceral injuries managed between 2009 and 2019 at a rural surgical hospital in Zambia were included. On admission, the patients were offered either urgent laparotomy or non-operative management (NOM) depending on their haemodynamic status. Continuous variables were expressed as median and mean ± standard deviation; categorical data were expressed as percentages. Statistical evaluation of data was performed by two-sample t-test. Statistical significance was assigned at p<0.05.

Results: fourty-three patients were included. The majority of victims sustained isolated spleen or liver injury. Twenty-three patients were urgently operated due to haemodynamic instability. Splenectomy performed in 17 patients, liver laceration sutured in 5 patients. One patient underwent concomitant splenectomy and liver repair. Conservative management was attempted in 20 (47%) patients and was successful in 18 (42%). In two patients NOM failed and splenectomy was performed urgently. Two patients died postoperatively. There were no deaths in NOM group.

Conclusion: NOM of patients with injury to solid abdominal organs could be safely initiated in rural hospitals provided there is uninterrupted monitoring of patients' condition, well-trained staff and unrestricted access to the operating theatre (OT).

Keywords: Blunt abdominal trauma; liver injury; non-operative treatment; regional hospital; spleen injury; surgery.

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Conflict of interest statement

The author declares no competing interests.

Figures

Figure 1
Figure 1
age distribution of patients with blunt trauma to the spleen and liver managed at Roan Antelope General Hospital over a period from 2009 to 2019
See this image and copyright information in PMC

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