Role of CT imaging in patients sustaining blunt injury of abdomen, retrospective analysis from a tertiary care hospital

Background: Blunt abdominal trauma is a frequently encountered emergency with associated significant morbidity and mortality. Since conservative nonsurgical therapy is preferred for all but the most severe injuries affecting the solid viscera, CT imaging is useful in detecting severe solid organ and bowel injuries which require surgical management. Objective: To analyze the profile of abdominal injuries presenting to the emergency medicine department of a tertiary care teaching hospital. Materials and methods: The study was a retrospective analysis of hospital records conducted in Velammal Medical College and Hospital, Madurai, which is a tertiary care teaching hospital in south India. The study was conducted from May 2014 to January 2016. People reporting to the emergency, with suspected abdominal injuries and evaluated for the same by CT abdomen were included in the study. Results: CT had 100% negative predictive value and highly specific in ruling out significant abdominal injuries. Spleen was the most common organ injured in study population, seen in 32 (42.10%) patients. The other common organs injured were liver and kidneys, which were injured in 24 (31.57%) and 16 (21.05%) patients respectively. Only 25% of the patients in our study required surgical intervention, which was for Grade IV/V splenic injuries, hepatic injury with active contrast extravasation, hepatic pseudo aneurysm, bowel and diaphragmatic injuries. Conclusions: CT is highly useful in evaluation of hemodynamically stable patients with suspected blunt abdominal trauma. Majority of the patients with abdominal injury were successfully managed conservatively.