Diagnostic Accuracy and Therapeutic Outcomes in Blunt Abdominal Trauma: Focus on Organ-Specific Injuries
DOI:
https://doi.org/10.37547/ajast/Volume05Issue05-20Keywords:
Blunt abdominal trauma, Organ injury severity, Diagnostic imaging, Trauma management, Surgical outcomes.Abstract
Blunt abdominal trauma (BAT) poses significant diagnostic and therapeutic challenges, particularly in resource-limited settings. This study evaluated organ-specific injury patterns, diagnostic accuracy, and management outcomes in a high-volume Iraqi trauma center.
A retrospective analysis of 280 BAT cases (2022–2023) was performed. Inclusion criteria were confirmed BAT via imaging (FAST, CT, or laparoscopy) or laparotomy. The data included demographics, injury mechanisms, AAST organ injury grades, management strategies (conservative vs. surgical), and outcomes (mortality and complications). Statistical analyses were performed using χ² and t-tests (SPSS v28).
The cohort was predominantly male (72.5%), with RTAs causing 78.6% of the injuries. The liver (42.1%) and spleen (31.4%) were the most frequently injured organs; pancreatic injuries had the highest mortality (18.2%). The CT outperformed the FAST in terms of sensitivity (94.3% vs. 82.4%) and specificity (89.5% vs. 76.8%). Conservative management was successful in 84.4% of renal injuries but failed in 66.7% of pancreatic cases. Negative laparotomy was performed in 14.6% of surgeries. Delayed intervention (>6 h) resulted in tripled mortality rates (30.0% vs. 4.4%, p<0.01).
BAT management requires organ-specific protocols, with CT being the cornerstone for diagnosis. Early intervention and judicious non-operative strategies for low-grade injuries can improve patient outcomes. These findings advocate strengthening the trauma system in comparable settings.
References
Mingxuan Li CW, Haixia Tu, Haitao Zhu, Zhen Guo, and Lianrui Guo. A systematic review of blunt abdominal aortic injury and analysis of predictors of death. Biomolecules and Biomedicine. 2024;24:486–504. doi: 10.17305/bb.2023.9831.
Sameer Ahmed Mohialdeen NKKS, Abbas Jaafar Alanbari. Abdomnial Vascular Injuries. MJBL. 2016;13:141-53.
Abbas Jaafar Khaleel Al-Anbari HA-AMA-H. Emergency thoracotomy of chest trauma: A cohort of 30 case series. Journal of Emergency Medicine, Trauma & Acute Care. 2024;16:1-9. doi: 10.5339/jemtac.2024.absc.11.
Wiik Larsen J, Søreide K, Søreide JA, Tjosevik K, Kvaløy JT, Thorsen K. Epidemiology of abdominal trauma: An age- and sex-adjusted incidence analysis with mortality patterns. Injury. 2022;53:3130-8. doi: 10.1016/j.injury.2022.06.020. PubMed PMID: 35786488.
Mirzamohamadi S, HajiAbbasi MN, Baigi V, Salamati P, Rahimi-Movaghar V, Zafarghandi M, et al.Yazdi SAM. Patterns and outcomes of patients with abdominal injury: a multicenter study from Iran. BMC Emergency Medicine. 2024;24:91. doi: 10.1186/s12873-024-01002-0.
K. P. Sritharshini Sv, Avikalp kumar. Evaluation of Blunt Abdominal Trauma Using CT: A Clinical Study. South Eastern European Journal of Public Health. 2025; Volume XXVI 3121-5. doi: 10.70135/seejph.vi.5615.
Zarama V, Torres N, Duque E, Arango-Ibañez JP, Duran K, Azcárate V, et al.Sánchez ÁI. Incidence of intra-abdominal injuries in hemodynamically stable blunt trauma patients with a normal computed tomography scan admitted to the emergency department. BMC Emergency Medicine. 2024;24:103. doi: 10.1186/s12873-024-01014-w.
O'Rourke MC, Landis R, Burns B. Blunt Abdominal Trauma. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Ryan Landis declares no relevant financial relationships with ineligible companies. Disclosure: Bracken Burns declares no relevant financial relationships with ineligible companies.: StatPearls Publishing Copyright © 2025, StatPearls Publishing LLC.; 2025.
Morell-Hofert D, Primavesi F, Fodor M, Gassner E, Kranebitter V, Braunwarth E, et al.Stättner S. Validation of the revised 2018 AAST-OIS classification and the CT severity index for prediction of operative management and survival in patients with blunt spleen and liver injuries. Eur Radiol. 2020;30:6570-81. doi: 10.1007/s00330-020-07061-8. PubMed PMID: 32696255; PubMed Central PMCID: PMCPMC7599164.
Agbroko S, Osinowo A, Jeje E, Atoyebi O. Determinants of Outcome of Abdominal Trauma in an Urban Tertiary Center. Niger J Surg. 2019;25:167-71. doi: 10.4103/njs.NJS_2_19. PubMed PMID: 31579371; PubMed Central PMCID: PMCPMC6771180.
Mehta N, Babu S, Venugopal K. An experience with blunt abdominal trauma: evaluation, management and outcome. Clin Pract. 2014;4:599. doi: 10.4081/cp.2014.599. PubMed PMID: 25332759; PubMed Central PMCID: PMCPMC4202181.
Fu C-Y, Bajani F, Bokhari M, Wang S-H, Cheng C-T, Mis J, et al.Bokhari F. How long of a postponement in surgery can a blunt hollow viscus injury patient tolerate? A retrospective study from the National Trauma Data Bank. Surgery. 2022;171:526-32. doi: 10.1016/j.surg.2021.06.017.
Gong J, Mei D, Yang M, Xu J, Zhou Y, Surgery. Emergency CT of blunt abdominal trauma: experience from a large urban hospital in Southern China. Quantitative Imaging in Medicine. 2017;7:461-8.
Atkins K, Schneider A, Charles A. Negative laparotomy rates and outcomes following blunt traumatic injury in the United States. Injury. 2023;54:110894. doi: 10.1016/j.injury.2023.110894.
Hardik J. Solanki HRP. Blunt abdomen trauma: a study of 50 cases. International Surgery Journal. 2018;5:1763-9. doi: 10.18203/2349-2902.isj20181447.
P. N R, T. R KK, G D. Challenges in management of blunt abdominal trauma: a prospective study. International Surgery Journal. 2018;5:3298-304. doi: 10.18203/2349-2902.isj20184078.
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Copyright (c) 2025 Raad Fadhel Al Rubaey, Sahal Mohammed Ali Jaber, Karrar Ibrahim Mahmood
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