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Pattern of visceral injuries following blunt abdominal trauma in motor vehicular accidents.

OBJECTIVE
To determine the frequency of various visceral injuries following, high-speed motor vehicle crashes with special reference to frequency of liver injuries, severity and complications.


DESIGN
A descriptive study.


PLACE AND DURATION OF STUDY
Surgical Unit III, Jinnah Hospital, Lahore, from August 1999 to February 2002.


PATIENTS AND METHODS
The study included 100 consecutive patients of blunt abdominal trauma. Patients of either gender and age above 12 and below 70 were included in this study. Purposive non-probability sampling was done. Injuries were identified, graded and managed accordingly. The data was then entered into SPSS and descriptive statistical tests were applied.


RESULTS
Liver was the most common organ injured (35%), followed by spleen (32 %) and small gut (30 %). In 23 patients, liver was the only organ injured. Most of the liver injuries fell under grade I (42.8%) followed by grade II (28.35%) and grade III (22.85%) and were treated by suture hepatorrhaphy alone in 71.42% cases. The operated cases were mostly complicated by wound infection (33.76%). Overall mortality remained high (12%) and was related to a combination of delays in arriving at a diagnosis due to non-availability of CT scan and routine use of peritoneal lavage.


CONCLUSION
Liver is the most commonly affected organ in high speed motor vehicle crashes that is reliably treated by suture hepatorrhaphy. The rate of postoperative infection and morbidity is high.