Blunt abdominal trauma. A review of 637 patients.

Although blunt abdominal trauma continues to cause significant morbidity and mortality, the care of these patients has improved significantly over the past 30 years. In order to evaluate the current status of management, we have reviewed retrospectively the medical records of all such patients admitted to the University of Mississippi Medical Center over a ten- year period (October 1, 1981 - September 30, 1991). Of the total of 637 patients, 61% were male and 39% female; 40% were between the ages of 20 and 29 years. Motor vehicle accidents accounted for approximately 80% of these injuries. Of the total, 399(62.6%) underwent laparotomy, 12 (3%) of which were nontherapeutic. The operative mortality rate was 13% and the overall mortality for the 637 patients was 8.5%. These results are compared with four previous series of blunt abdominal trauma patients. Women comprised a greater proportion in the two most recent series. The liver and spleen are the most commonly injured intra-abdominal organs; however, liver injuries have been reported in increasing numbers of patients in the most recent series. The incidence of nontherapeutic laparotomy is less with each succeeding series. Mortality rates have declined significantly and the 8.5% mortality in our patients is certainly indicative of this trend.