Trauma is present since the beginning of mankind. The incidence of blunt abdominal trauma is increasing. In spite of improved diagnosis and management, blunt trauma abdomen has significant morbidity and mortality. It is one of the leading preventable cause of the unnatural deaths in developed and developing countries. Blunt abdominal trauma comprises about 75% of all blunt trauma cases [1]. The common causes of blunt abdominal trauma are road traffic accidents, fall from height, sports injuries and violence. Road traffic accidents account for 75-80 % cases of blunt abdominal trauma [2].

In developing countries trauma in general and abdominal trauma in particular is increasing at a fast rate due to increase in urbanization, motorization, civil violence, wars and criminal activities and sports. The etiological spectrum and mechanism of injury in abdominal trauma, varies from one part of the world to another part due to variations in infrastructures, civil violence, wars and crime. The objective of the study was to understand the clinical spectrum of blunt trauma abdomen among the patients admitted in the department of general surgery at Indira Gandhi Medical College, Shimla, Himachal Pradesh.

It was a descriptive cross-sectional study that was conducted on the patients with blunt abdominal trauma in the department of General Surgery over a period of one year. The data was cleaned and entered using Microsoft excel spreadsheet and was analyzed using SPSS version 16. The quantitative variables were expressed in mean and standard deviation whereas the qualitative variables were expressed in frequencies and proportions.

A total of 400 patients of blunt trauma abdomen were studied during this period. Patients who sustained Blunt Abdominal Trauma due to Road traffic accidents, fall from height, assault or any other mode of injury having abdominal tenderness, evidence of external injury mark and dangerous mode of injury were clinically examined as per ATLS guidelines. Patients were immediately resuscitated and investigated. Ultrasound FAST was done and patients having evidence of free fluid in abdomen were subjected to CECT abdomen.

Mean age of the patient was 37.13 years with minimum age of 8 years and maximum age of 85 years. Most of patients (50.50%) were in between 21-40 years of age and maximum cases (30.00%) were found in age group 21- 30 years (Figure 1).

Out of 400 patients, 305 (76.25 %) patients were males and 95 (23.75 %) patients were females with male to female ratio of 3.21:1. There were 26 children, out of which, 21 (5.25%) were male children and 5 (1.25%) were female children.

On initial examination at presentation, tenderness was present in 310 (77.5 %) patients, external injury marks were present in 85 (21.25 %) patients. Guarding and rigidity were present in 76 (19 %) and 30 (7.5 %) patients respectively. Distension of abdomen was seen in 28 (7 %) patients (Table1).

Figure 1: Distribution of Patientd According to Different Age Groups

Table 1: Clinical Presentation of the Study Participants (N = 400)

In our study Maximum number of patients were in the age group of 21-30 years. In a study by Ahmed and Beckingham also, young males aged 21- 30 years were the most frequent victims of blunt abdominal trauma [3]. Although no age group was exempted from traumatic injury of abdomen. Young adults are more prone to blunt abdominal trauma because of more exposure to day to day hazards of work and road traffic use.

In our study, 76.25% of patients were male and 23.75% patients were females with male to female ratio came out to be 3.21:1. As per literature, blunt trauma injuries are common in males than in females [4]. In a study by Mohammad et al., significantly more males as compared to females were involved in abdominal trauma 87.1% vs 12.9% [5]. The incidence ratio of male to female reported by Lone et al., was 4.4:1 among abdominal trauma patients [6]. This is also due to more exposure of males to occupational hazards and traffic as compared to females.

In the present study most, common symptom was pain abdomen (100%). Abdominal tenderness was noted in 77.5% patients, external injury marks was seen in 21.25% patients, abdominal distension was seen in 7% patients, abdominal guarding was observed in 19% patients and abdominal rigidity was noted in 7.5% patients. In a study by Srihari et al., the most common symptom was pain abdomen (96.6%), followed by abdominal tenderness (85%). Abdominal distension was present in (50%) followed by vomiting and haematuria. Local or generalized guarding was see in 48% cases [7]. In another study by Magray et al., abdominal pain was the most common symptom observed in blunt abdominal trauma patients (77%). Abdominal tenderness was the most common sign observed (72%) [8]. Thus our findings corroborate with other studies.

Most of our study participants were males between the age group of 21 years and 40 years. Most common clinical presentation was abdominal tenderness. Further studies need to be done to understand the risk factors responsible for blunt trauma abdomen in these younger and economically productive age groups.

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2. Bankar, S.S. et al. “Duodenal transection without pancreatic injury following blunt abdominal trauma.” Journal of Surgical Technique and Case Report, vol. 6, no. 2, 2014, pp. 67–69.

3. Ahmed, I. and I.J. Beckingham. “Liver trauma.” Trauma, vol. 9, 2007, pp. 171–180.

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6. Lone, G.N. et al. “An experience with abdominal trauma in adults in Kashmir.” JK Practitioner, vol. 8, no. 4, 2001, pp. 225–230.

7. Srihari, V. et al. “A clinical study of blunt injury abdomen.” Paripex-Indian Journal of Research, vol. 4, no. 1, 2015.

8. Magray, M. et al. “Studying the role of computed tomography in selective management of blunt abdominal trauma patients in a single tertiary care centre in northern India.” The Internet Journal of Surgery, vol. 30, no. 2, 2013, pp. 1–6.