Incidence, patterns, and factors associated with mortality in penetrating abdominal trauma patients
Article Details
Background: Trauma is a major source of morbidity and mortality in the United States, Penetrating trauma encompasses a wide range of mechanisms that can be generically classified as ballistic (gunshot wounds) and non-ballistic trauma (stab and other puncture wounds). Firearm-related injuries account for the majority of fatalities from penetrating trauma, while cuts/piercings account for the majority of non-fatal instances worldwide. The Aim: To evaluate injury patterns of patients admitted to the hospital with penetrating abdominal trauma, mortality rate, and the factors associated with it. Methods: a cross-sectional study done in Imam Hussein Teaching Hospital, Al-Habobi general hospital and the Turkish general hospital / AL-Nasiriyah-Iraq, to determine the frequency of different abdominal organ injury and mortality rate due to penetrating abdominal trauma in 180 patients during the period of 1st of February, 2021 to 31st of March 2022. Results: The mean age was 34.53 years old. Males were predominant 146 (81.1 %). Small Bowel was the most injured organ (47.2%) followed by large bowel (27.8%). Half of the participants had only one organ injury, and the major mechanism of penetrating injury was sharp objects in about 51% of them. The mortality rate was 8% among participants and there was a significant association between the death rate with the number of injured organs. Conclusion: A high proportion of penetrating abdominal trauma caused by sharp objects or tools and the most affected was young to middle age males. Small intestine was the most injured organ, however, low mortality rate in compared to other studies was noted
2. Bradley M, Nealeigh M, Oh JS, Rothberg P, Elster EA, Rich NM. Combat casualty care and lessons learned from the past 100 years of war. Current Problems in Surgery. 2017 Jun 1;54(6):315-51.
3. Jansen JO, Thomas R, Loudon MA, Brooks A. Damage control resuscitation for patients with major trauma. Bmj. 2009 Jun 5;338.
4. Soomro SH, Shaikh SA, Abro AA, Shaikh MS. PENETRATING ABDOMINAL TRAUMA: OUR EXPERIENCE. Medical Channel. 2010 Oct 1;16(4).
5. Singh UC, Jina A. ABDOMINAL INJURY AND ITS OUTCOME--A PROSPECTIVE STUDY IN A TERTIARY HEALTH CARE CENTER. Journal of Evolution of Medical and Dental Sciences. 2019 May 6;8(18):NA-.
6. Wani M, Chalkoo M, Makhdoomi PH, Banotra A, Sofi MY. Penetrating Abdominal Trauma; An Overview of Recent Turmoil in Kashmir Valley. J Surgery. 2016;4(2):3.
7. Ertan T, Sevim Y, Sarigoz T, Topuz O, Tastan B. Benefits of CT tractography in evaluation of anterior abdominal stab wounds. The American Journal of Emergency Medicine. 2015 Sep 1;33(9):1188-90.
8. Biffl WL, Leppaniemi A. Management guidelines for penetrating abdominal trauma. World journal of surgery. 2015 Jun;39(6):1373-80.
9. Richards JR, McGahan JP. Focused assessment with sonography in trauma (FAST) in 2017: what radiologists can learn. Radiology. 2017 Apr;283(1):30-48.
10. Shlamovitz GZ, Mower WR, Bergman J, Crisp J, DeVore HK, Hardy D, Sargent M, Shroff SD, Snyder E, Morgan MT. Poor test characteristics for the digital rectal examination in trauma patients. Annals of emergency medicine. 2007 Jul 1;50(1):25-33.
11. Malgras B, Prunet B, Lesaffre X, Boddaert G, Travers S, Cungi PJ, Hornez E, Barbier O, Lefort H, Beaume S, Bignand M. Damage control: concept and implementation. Journal of visceral surgery. 2017 Dec 1;154:S19-29.
12. Kruger AM. Review of Damage Control Laparotomy (DCL) outcomes in a Major Urban Trauma Center (Master's thesis, Faculty of Health Sciences).
13. Peev MP, Chang Y, King DR, Yeh DD, Kaafarani H, Fagenholz PJ, De Moya MA, Velmahos GC. Delayed laparotomy after selective non-operative management of penetrating abdominal injuries. World journal of surgery. 2015 Feb;39(2):380-6.
14. Waibel BH, Rotondo MF. 19 Damage Control Laparotomy. Trauma, Critical Care and Surgical Emergencies. 2016 Apr 19:174.
15. Stamatatos I, Bouboulis K, Metaxas E, Klapsakis D, Anagnostopoulos G, Tzagkarakis F, Dimitriadis I, Konstas A, Louverdis D, Rogdakis A. Damage Control and Staged Management in Zone 1 Vascular Abdominal Trauma. J Trauma Care. 2018;4:1030.
16. BARADARAN B, Salimi J, NASAJI ZM, Khaji A, RABANI A. Epidemiological study of patients with penetrating abdominal trauma in Tehran-Iran.
17. Inaba K, Okoye OT, Rosenheck R, Melo N, Branco BC, Talving P, Lam L, Reddy S, Salim A, Demetriades D. Prospective evaluation of the role of computed tomography in the assessment of abdominal stab wounds. JAMA surgery. 2013 Sep 1;148(9):810-6.
18. Asuquo ME, Bassey OO, Etiuma AU, Ugare G, Ngim O. A prospective study of penetrating abdominal trauma at the University of Calabar Teaching Hospital, Calabar, Southern Nigeria. European Journal of Trauma and Emergency Surgery. 2009 Jun;35(3):277-80.
19. Naeem BK, Perveen S, Naeem N, Ahmed T, Khan I, Khan I, Tahir M, Iqbal M. Visceral injuries in patients with blunt and penetrating abdominal trauma presenting to a tertiary care facility in Karachi, Pakistan. Cureus. 2018 Nov 17;10(11).
20. Pooria A, Pourya A, Gheini A. A descriptive study on the usage of exploratory laparotomy for trauma patients. Open Access Emergency Medicine: OAEM. 2020;12:255.
21. Lotfollahzadeh S, Burns B. Penetrating abdominal trauma. InStatPearls [Internet] 2021 Aug 27. StatPearls Publishing
22. Dijkink S, Krijnen P, Hage A, Van der Wilden GM, Kasotakis G, Hartog DD, Salim A, Goslings JC, Bloemers FW, Rhemrev SJ, King DR. Differences in Characteristics and Outcome of Patients with Penetrating Injuries in the USA and the Netherlands: A Multi-institutional Comparison. World journal of surgery. 2018 Nov;42(11):3608-15.
23. Kieltyka J, Kucybala K, Crandall M. Ecologic factors relating to firearm injuries and gun violence in Chicago. Journal of forensic and legal medicine. 2016 Jan 1;37:87-90.
24. Petros FG, Santucci RA, Al-Saigh NK. The incidence, management, and outcome of penetrating bladder injuries in civilians resultant from armed conflict in Baghdad 2005-2006. Advances in urology. 2009 Jan 1;2009.
25. Iflazoglu N, Ureyen O, Oner OZ, Tusat M, Akcal MA. Complications and risk factors for mortality in penetrating abdominal firearm injuries: analysis of 120 cases. International journal of clinical and experimental medicine. 2015;8(4):6154.
26. Tyburski JG, Wilson RF, Dente C, Steffes C, Carlin AM. Factors affecting mortality rates in patients with abdominal vascular injuries. Journal of Trauma and Acute Care Surgery. 2001 Jun 1;50(6):1020-6.