Evaluation of blunt trauma patients according to CT scan and intraoperative findings

Abstract

Introduction: Abdominal blunt trauma is one of the most important causes of mortality and morbidity in all ages. Predicting the possibility of serious intra-abdominal injury and dividing patients into low-risk and high-risk patients is of great importance in medical and diagnostic decision making. The aim of this study was to evaluate abdominal blunt trauma patients with CT scan and intraoperative findings. Material and Methods: This was a descriptive retrospective study. The study population consisted of all patients with abdominal blunt trauma referred to Emergency Surgery Shahid Beheshti Hospital, Kashan in 2017, who were CT-scanned and underwent surgery. Patients with abnormal CT scan, or normal CT scan, with only positive clinical symptoms, were candidates for surgery and laparotomy and all injuries to their abdominal organs including spleen, kidney, liver and intestinal injury were then evaluated during surgery. Data were analyzed using SPSS 16.0. Results: In this study 199 patients with abdominal blunt trauma were studied. Of the 199 patients, 77 had liver damage, followed by kidney injuries (51 patients), spleen injuries (125 patients) and intestinal damage (27 patients). There were 280 concurrent abdominal injuries in some traumatic patients. Frequency distribution of patients with abdominal blunt trauma according to the type of injury in surgery was related to spleen (123 patients, 38.7), liver (83 patients, 26), intestine (62 patients, 19.6) and kidney (50 patients, 15.7). Conclusion: According to the results of the present study, the diagnostic value of clinical symptoms is comparable to the value of CT scan in traumatic patients and due to the high cost of CT scan and its deleterious effects on individuals, it can be concluded that in patients with positive clinical symptoms, CT scans are not necessary, and CT scans along with clinical symptoms can be helpful if the surgeon is suspicious of the clinical symptoms, therefore, leading to elimination of the financial burden and its effects from the healthcare system.