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    Miftahuljannah S 1510029032: Blunt Trauma To Abdomen in Rural Setup: A Multiple Case Study

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    Sudirman Diah
    This study examined 68 cases of blunt abdominal trauma at a rural hospital over two years. The results showed that blunt abdominal trauma was most common in males in their third decade of life who worked as farmers. Road traffic accidents accounted for 75% of cases. The spleen was the most commonly injured organ. Diagnostic tools available in rural areas like physical exams, x-rays, and ultrasounds were effective at diagnosis. Laparotomy was performed in 28% of cases to locate and repair injuries. The mortality rate was 14.7% primarily due to hemorrhagic shock.

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    Miftahuljannah S 1510029032: Blunt Trauma To Abdomen in Rural Setup: A Multiple Case Study

    Uploaded by

    Sudirman Diah
    8 views20 pages
    This study examined 68 cases of blunt abdominal trauma at a rural hospital over two years. The results showed that blunt abdominal trauma was most common in males in their third decade of life who worked as farmers. Road traffic accidents accounted for 75% of cases. The spleen was the most commonly injured organ. Diagnostic tools available in rural areas like physical exams, x-rays, and ultrasounds were effective at diagnosis. Laparotomy was performed in 28% of cases to locate and repair injuries. The mortality rate was 14.7% primarily due to hemorrhagic shock.

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    This study examined 68 cases of blunt abdominal trauma at a rural hospital over two years. The results showed that blunt abdominal trauma was most common in males in their third decade of life who worked as farmers. Road traffic accidents accounted for 75% of cases. The spleen was the most commonly injured organ. Diagnostic tools available in rural areas like physical exams, x-rays, and ultrasounds were effective at diagnosis. Laparotomy was performed in 28% of cases to locate and repair injuries. The mortality rate was 14.7% primarily due to hemorrhagic shock.

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    8 views20 pages

    Miftahuljannah S 1510029032: Blunt Trauma To Abdomen in Rural Setup: A Multiple Case Study

    Uploaded by

    Sudirman Diah
    This study examined 68 cases of blunt abdominal trauma at a rural hospital over two years. The results showed that blunt abdominal trauma was most common in males in their third decade of life who worked as farmers. Road traffic accidents accounted for 75% of cases. The spleen was the most commonly injured organ. Diagnostic tools available in rural areas like physical exams, x-rays, and ultrasounds were effective at diagnosis. Laparotomy was performed in 28% of cases to locate and repair injuries. The mortality rate was 14.7% primarily due to hemorrhagic shock.

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    of 20

    International Journal of Scientific Study | July 2015 | Vol 3 | Issue 4 Journal Reading

    Blunt Trauma to Abdomen in Rural Setup:


    A Multiple Case Study
    Shantanu Kulkarni, Vijay Kanase, Naseema Kanase, Pratap Varute

    Miftahuljannah S
    1510029032
    Clinical advisor
    dr. Wahyu Adhianto, Sp.B
    Laboratorium/SMF Ilmu Bedah
    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    Introduction

    Since high-speed surface travel is becoming more universally available, it


    is certain that blunt trauma will continue to comprise an important
    fraction of the major injuries which the surgeon is called upon to treat

    Accurate diagnosis and avoidance of needless surgery are an important


    goal of evaluation

    When the diagnosis is in doubt, and clinical judgment suggests surgery,


    exploration provides definitive treatment as well as a diagnosis

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    Hence, the new techniques and diagnostic tools available
    are important in the management of abdominal trauma,
    especially blunt trauma

    These improved methods and diagnostic tools, however,


    still depend on availability in rural area, experience and
    clinical judgment for application and determination of the
    best care for the injured patient.

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    • Aims and Objectives
    1. To study the etiology of blunt abdominal trauma in
    this area.

    2. To study different organs injured when a person


    sustains blunt trauma to the abdomen.

    3. To study mortality in relation to various factors

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    MATERIALS AND METHODS

    A prospective study of 68
    consecutive cases of blunt
    trauma to abdomen admitted to
    a tertiary hospital in a rural area
    over a period of 2 years was
    studied in detail.
    Laboratorium/SMF Ilmu Bedah
    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    • Detailed history
    • time of injury
    • type of injury
    • cause of injury
    • site of injury over the
    abdomen
    • injury to admission interval
    Full was noted
    • So also size of vehicle
    registration • position of patient
    • type of impact was noted in
    road traffic accident

    • Thorough clinical examination


    was carried out in all patients

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    • Special blood
    investigations
    • plain X-ray erect abdomen
    • ultrasonography (USG) of
    the abdomen
    • X-Ray chest, spine, pelvis
    • intravenous pyelogram
    • computed tomography
    (CT) scan were done as
    required.

    • Patients in shock were


    resuscitated initially

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    Results were computed as
    percentages of total participants.
    Furthermore, data were internally
    compared for age and gender, and
    outcomes were also compared
    accordingly and was tabulated.
    Laboratorium/SMF Ilmu Bedah
    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    Observation and Result
    Sex % Occupation %

    Male 94% Farmers 30.88%


    Females 6% Students 26.47%

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    About 70% patients presented to
    the hospital within 4 h of trauma.
    Earliest were two patients who
    came to the hospital within 15 min
    while one patient got admitted
    after 4 days

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    Laboratorium/SMF Ilmu Bedah
    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    This process was confirmed by
    erect X-ray abdomen and USG
    abdomen. Gas under diaphragm
    was the most common finding
    on X-ray, while the collection in
    the abdomen was the most
    common finding on USG

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    About 53% patients of blunt
    abdominal trauma showed
    associated injuries. Head injury was
    an associated injury in 22 patients
    while chest trauma was seen in 14
    cases.

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    Minimum hospital stay was 1 day
    while the maximum hospital stay
    was 32 days, with an average
    hospital stay of 8 days

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    The most common cause of
    mortality was hemorrhagic
    shock. Of 68 patients, 10 died
    (14.7%). Of these 6 patients died
    within an hour of admission
    during resuscitation itself.

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    DISCUSSION

    Blunt abdominal is on the rise because of easy availability


    and use of motor vehicles, increase in crime and violence.

    Blunt abdominal trauma was commonly seen in the 3rd


    decade of life, in farmers and had a male preponderance.
    This is because males are more exposed to outdoor activity
    and farming while women are still the homely type in a rural
    area like ours

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    Road traffic accident is the commonest cause of blunt
    abdominal trauma. Motor vehicle accidents (75%) and
    urban violence are the leading cause of blunt and
    penetrating abdominal trauma to this area of the body.

    Diagnostic accuracy of the erect X-ray abdomen was


    100%. So in rural areas, it is a valuable and simple non-
    invasive

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    In our study, 28% patients underwent laparotomy.
    Laparotomy was carried out to locate and repair injured
    viscera/organ, inspect abdominal cavity for other injuries,
    clean peritoneal cavity and control contamination and also
    to give the patient a definite treatment.

    The spleen is the most commonly injured organ. Splenic


    injuries may be life-threatening even in the patient who
    appears hemodynamically stable with missed intra
    abdominal injuries

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    CONCLUSION
    • Blunt abdominal trauma is on the rise.
    • Blunt trauma to the abdomen is common in the 3rd decade of life, in
    males, farmers and due to road traffic accidents.
    • Sono-radio diagnosis helps in arriving at a conclusive diagnosis and
    aids in treatment in the rural area.
    • The small bowel, spleen, and mesentery are commonly injured in
    blunt abdominal trauma.
    • Mortality is commonly due to hemorrhagic shock and is seen more if
    associated head and chest injuries are present.
    • Early admission, intransit resuscitation, diagnosis and prompt and
    appropriate treatment can save lives.

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017
    -THANK YOU-

    Laboratorium/SMF Ilmu Bedah


    Fakultas Kedokteran
    Universitas Mulawarman
    2017

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