TITLE:
Penetrating Abdominal Injuries: Pattern and Outcome of Management in Khartoum
AUTHORS:
Maha Yassin Omer, Aamir Abdullahi Hamza, Mohammed Toum Musa
KEYWORDS:
Mandatory Laparotomy; Mortality; Non-Operative Management; Penetrating Abdominal Injuries
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.5 No.1,
January
8,
2014
ABSTRACT:
Background: The pattern and presentation of penetrating abdominal trauma vary
according to places and the structure of the present health system. As well
controversies in management exist ranging from mandatory exploration to
selective non-operative management. Objectives:
To determine the pattern of penetrating abdominal trauma, current management
practiced and outcome in Khartoum. Patients
and Methods: The study was prospective, descriptive and hospital-based.
It was carried out at the main three hospitals in Khartoum State. It was
conducted over a period of one year from 2012 Mar to 2013 Mar. All patients who
presented penetrating injury to their abdomen were included. Results: The study included 85 patients with a mean age of
28 years (SD ± 10). The male to female ratio was 11:1. Most of the patients (89.4%)
were in the first four decades of their life. Twenty-three patients (27.1%)
presented shock. Stab wound is the commonest mode of trauma seen in 83.5% of
our patients. The majority of our patients were managed by exploratory
laparotomy (81.2%), however 16 (18.8%) underwent conservative measures. Of the
operated group, solid organ injuries were found in 22.9%, yet hollow viscous
injuries were reported in 86.9% of the patients. Registrars operated on 78.26%
of the patients. The rate of negative
laparotomy of this study was 8.7%. Complications and mortality were encountered
in 25.9% and 4.7% respectively. The mean hospital stay was 8.47 days (SD
± 10.6). Conclusion: This study demonstrates no difference in the
pattern of intra-abdominal injuries. The rate of operative treatment is
acceptable, but more laparotomies can be avoided if the haemodynamic stable
patients without features of peritonitis were given a period of observation.
The overall outcome was satisfactory.