Naeem Bushra Kiran, Perveen Sughra, Naeem Nadia, Ahmed Tanweer, Khan Iqbal, Khan Imran, Tahir Muhammad, Iqbal Mazhar
General Surgery, Jinnah Post Graduate Medical College, Karachi, PAK.
Miscellaneous, Dow University of Health Sciences (DUHS), Karachi, PAK.
Cureus. 2018 Nov 17;10(11):e3604. doi: 10.7759/cureus.3604.
Introduction Abdominal injuries are responsible for 10% of the mortalities due to trauma. Delays in early diagnosis or misdiagnoses are two major reasons for the mortality and morbidity associated with abdominal trauma. The objectives of this study were to determine the frequency of visceral injuries in patients with abdominal trauma and compare the frequency of visceral injuries in patients with blunt and penetrating abdominal trauma. Methods We conducted a cross-sectional study from May 2016 to May 2018 of patients presenting to the emergency department (ED) at Jinnah Postgraduate Medical Center in Karachi, Pakistan. Patients were 12 to 65 years old and presented within 24 hours of abdominal trauma. We recorded the type of abdominal visceral injuries, such as liver, spleen, intestine, stomach, mesentery, and pancreas. Results The mean patient age was 31 ±13 years. Penetrating trauma was found in most patients (n=72, 51%). Liver injuries were found in 37 patients (26.4%), spleen injuries in 29 patient (20.7%), stomach injuries in eight patients (5.7%), intestine injuries in 67 patients (47.9%), mesentery injuries in 21 patients (15%), and pancreas injuries in nine patients (6.4%). The type of abdominal trauma was found significantly associated with liver injury (p-value 0.021), and intestine injury (p-value <0.001). Conclusion Penetrating trauma (51.4%) was more common than blunt trauma (48.5%), and intestines are the most commonly affected by penetrating and blunt trauma injuries (70.1% and 47.8%, respectively). The liver is the most commonly affected (42.85%) in blunt trauma injuries, followed by the spleen (28.5%). The appropriate authorities should consider this information when instituting public health and safety initiatives.
引言
腹部损伤占创伤致死率的10%。早期诊断延误或误诊是腹部创伤相关死亡率和发病率的两个主要原因。本研究的目的是确定腹部创伤患者内脏损伤的发生率，并比较钝性和穿透性腹部创伤患者内脏损伤的发生率。
方法
我们于2016年5月至2018年5月在巴基斯坦卡拉奇真纳研究生医学中心急诊科对患者进行了一项横断面研究。患者年龄在12至65岁之间，在腹部创伤后24小时内就诊。我们记录了腹部内脏损伤的类型，如肝脏、脾脏、肠道、胃、肠系膜和胰腺。
结果
患者的平均年龄为31±13岁。大多数患者（n = 72，51%）为穿透性创伤。37例患者（26.4%）有肝脏损伤，29例患者（20.7%）有脾脏损伤，8例患者（5.7%）有胃损伤，67例患者（47.9%）有肠道损伤，21例患者（15%）有肠系膜损伤，9例患者（6.4%）有胰腺损伤。发现腹部创伤类型与肝脏损伤（p值0.021）和肠道损伤（p值<0.001）显著相关。
结论
穿透性创伤（51.4%）比钝性创伤（48.5%）更常见，肠道是穿透性和钝性创伤中最常受影响的部位（分别为70.1%和47.8%）。钝性创伤中最常受影响的是肝脏（42.85%），其次是脾脏（28.5%）。相关部门在制定公共卫生和安全举措时应考虑这些信息。
