Demography and Presentation of Abdominal Injury in a Tertiary Care Polytrauma Centre in South Tamil Nadu

DEMOGRAPHY AND PRESENTATION OF ABDOMINAL INJURY IN A TERTIARY CARE POLYTRAUMA CENTRE IN SOUTH TAMIL NADU. Dr. R. R. Kannan Mch (Gastro) ^1, FICS, Dr. C. C. Nandhini M. D (OG) ^2, FICOG, Dr. Sathish Devadoss MS, MCh^3, Dr. A. Devadoss Dsc, FRCS^3, Dr. R. Sudir DNB^3 (_^1) Senior consultant surgical gastroenterologist, Institute of Orthopedic Research and Accident Surgery, Madurai and Associate professor, K. A. P. V. Government Medical College, Trichy. (_^2) Senior assistant professor, Govt. Rajaji hospital and Madurai medical college, Madurai. (_^3) Institute of Orthopedic Research and Accident Surgery, Madurai. Corresponding Author (_^1) Dr. R. R. Kannan Mch (Gastro), FICS. , Senior consultant surgical gastroenterologist, Institute of Orthopedic Research and Accident Surgery, Madurai and Associate professor, Department of Surgical gastroenterology and Proctology, K. A. P. V. Government Medical College, Trichy, Tamil Nadu, India. Email kannanramana1971@gmail. com Demography, presentation, Abdominal injuries, polytrauma Introduction Abdominal injury in polytrauma ranks third among the most frequently injured body region and quarter of them need exploration.10 % of trauma related deaths are due to abdominal injury. It requires early resuscitation in the golden hours, high index of suspicion of visceral injury, proper investigation and early surgical intervention in required patients and non-operative management (NOM) for appropriate patients to avoid morbidity and preventable mortality in abdominal trauma patients. Aim It is a retrospective observational study conducted for three years from 1st January 2014 to 31st December 2017 at Institute of Orthopedic Research and Accident Surgery, Madurai, at Devadoss Multispecialty Hospital, a private tertiary teaching polytrauma institution at Madurai, South Tamil Nadu, India. Analysis is based on the method of presentation to emergency department, mode of injuries, demography, associated injuries, non-operative management, surgical management, pattern of injuries at laparotomy, hospital stay and overall outcome in patients of abdominal injury in polytrauma. Materials and Methods 111 patients were included in this study period of three years. Patients who left the hospital against medical advice and aged below 12 years were excluded from the study. Detailed history, clinical examination, appropriate investigations done and various treatment modalities followed including surgeries, intra-operative findings, non-operative management, hospital stay and outcome recorded in the case sheet were analyzed by statistical methods. Result Study showed road traffic accidents were the commonest mode of injury. Age group most commonly involved is middle age. Males were affected more than female. Spleen was the commonest solid viscera injured and small bowel was the commonest hollow viscera injured in our study. Non-operative management was followed in haemodynamically stable patients with solid organ injury. All hollow visceral injury underwent laparotomy. Conclusion In recent years, high speed road traffic accidents are drastically increasing in number and magnitude because of fast moving vehicle in four track roads. Educating the traffic rules to everyone and strictly following them will definitely reduce the incidence of accidents. Our study insists on the steps to be taken in the golden hours and the importance of early surgical intervention in time in the needy cases to reduce the morbidity and preventable mortality.