Document Type : Original Article
Department of Surgery, UCMS and GTB hospital, Delhi, India
Department of Surgery, ABVIMS & Dr. Ram Manohar Lohia hospital, Delhi, India
Department of Radiodiagnosis, VMMC & Safdarjung Hospital, New DELHI, India
Department of Pathology, Jyoti Gupta Clinic, Delhi, India
Background: Non-operative management (NOM) has shown success in the management of cases of blunt abdominal trauma (BAT), especially in hemodynamically stable patients, even if there is a higher grade of injury.
Objectives: The aim of this study was to determine the healing rate with NOM and associated risk factors of non-healing in patients with BAT.
Methods: This prospective study was conducted on 20 hemodynamically stable patients of BAT who were treated in a tertiary care hospital by NOM. Clinical monitoring and biochemical investigations were done. The patients were followed-up for three months. The outcome measures were the average time of healing and complications. A p-value less than 0.05 was considered statistically significant.
Results: The mean age of the patients was 24.5 years with 18 (90%) males and 2(10%) females. Nine patients (45%) had isolated liver injury, 8 (40%) had isolated splenic injury, 1 (5%) had isolated left renal injury, 1 (5%) had combined liver and splenic injury and 1 (5%) had combined liver and right renal injury. At 3 months of follow-up, 16 (80%) cases showed complete healing, 3(15%) showed incomplete healing and 1 (5%) patient with grade 4 splenic injury had failure of NOM. On performing univariate regression analysis, grade 3/4 was an independent risk factor of non-healing with an odds ratio of 5.667.
Conclusion: In conclusion, NOM appears to be a safe and effective management protocol for patients with BAT, provided regular follow-ups and monitoring are done.
Ketan Garg [Pubmed] [Google Scholar]