Gastrointestinal Injuries in Blunt Abdominal Traumas
D. Gönüllü, S. Ilgun, M.L. Gedik, O. Demiray, Z. Öner, M. Er, F.N. KöksoyOriginal article, no. 4, 2015
Aim: To discuss the efficiency of RTS (Revised TraumaScore), ISS (Injury Severity Score), and factors that affectmortality and morbidity in gastrointestinal injuries due toblunt trauma.Method and methods: Patients with gastrointestinal injuriesdue to blunt trauma operated within the last six years havebeen studied retrospectively in terms of demographics,injury mechanism and localization, additional injuries, RTS and ISS, operative technique, morbidity, mortality andduration of hospitalization.Findings: Of the eighteen cases, cause of injury was a trafficaccident for 11 (61.1%), fall from height for 5 (27%) andphysical attack for 2 (11%). Among the eighteen patients,there were 21 gastrointestinal injuries (11 intestinal, 6 colon,3 duodenum, 1 stomach). 10 (55.6%) had additional intraabdominalinjuries while the number for extra-abdominalinjuries were 12 (66.7%). Primary suture (10), segmentaryresection (9) and pyloric exclusion (2) were the operationsperformed for the twenty-one gastrointestinal injuries.Although statistically not significant, 13(72.2%) patientswith additional injuries compared with 5 (27.8%) patientswith isolated gastrointestinal injuries, were found to havelower RTS (7.087/7.841), higher ISS (19.4/12.2), longerduration of hospitalization (11.5/8.4 day) as well as highermorbidity (7/1) and mortality (2/0) rates. Comparing theRTS (7.059/7.490) of patients who have and have notdeveloped morbidity revealed no significant difference.However, ISS (23.9/12.2) was significantly higher in patientswho have developed morbidity (p=0.003). RTS (6.085 7.445) and ISS (39.5/14.6) of patients who have survivedwere significantly different than patients who have not(p=0.037 and p=0.023, respectively)
Conclusion: Additional injuries in patients with gastrointestinalinjury due blunt abdominal traumas increases, although not significantly, morbidity, mortality and durationof hospitalization even when operated early. High ISS issignificantly related to the risk of both morbidity andmortality while low RTS is significantly related only to themortality risk.
