[Surgical management of blunt abdominal trauma]

From 1986 to 1990, 175 patients with blunt abdominal trauma were hospitalized and operated on in Kuang Tien General Hospital. Included were 140 males and 35 females with a mean age of 33 years (range: 2 to 82). The mean duration of the follow-up was 42 months. We classified the severity of the injured organs with the organ injury scale which was published by the Organ Injury Scaling (O.I.S.) Committee of the American Association for the Surgery of Trauma (A. A. S. T.) in 1989 and 1990. Among the patients, 12 cases were treated with splenorrhaphy. Eighty-two cases underwent splenectomy. Four cases underwent partial resection of the liver. Three cases required repair of the inferior vena cava. Seventeen cases were treated with partial resection of the small intestine and anastomosis. Seven cases underwent colostomy. Three cases were treated with distal pancreatectomy. Nineteen cases underwent nephrectomy. One case was treated with partial nephrectomy. The mortality rate was 6.3%, and the morbidity rate 20.6%. The most frequent postoperative complications related to blunt abdominal trauma in the patients who survived the initial operation were wound infection (8.0%), small bowel obstruction (4.0%), pulmonary infection (2.3%), intra-abdominal abscesses (2.3%), pancreatitis (1.7%), pancreatic fistula (1.7%), and pseudocyst (0.6%).