Patterns, Severity, and Outcomes of Solid Organ Injuries in Abdominal Trauma: A Prospective Observational Study.

BACKGROUND

Solid organ injuries in blunt abdominal trauma cause significant morbidity and mortality, necessitating early severity assessment.

OBJECTIVES

The primary aim is to evaluate the pattern and severity of solid organ injuries after abdominal trauma. The secondary objectives of the study are to correlate injury severity with clinical, biochemical, and radiological parameters and to evaluate management strategies and short-term outcomes.

METHOD: This prospective observational study included patients presenting with blunt abdominal trauma and radiologically confirmed solid organ injuries. Injuries to the liver, spleen, kidney, and pancreas were graded according to the American Association for the Surgery of Trauma (AAST) classification. Clinical parameters, shock index, laboratory values, imaging findings, and management strategies were recorded and analyzed.

RESULTS

Young males predominated, and road traffic accidents were the leading cause of injury. The liver and spleen were the most frequently injured organs. Higher AAST grades were associated with increased shock index values (>0.9), greater hemodynamic instability, and significant derangement of biochemical parameters, including elevated serum transaminases in liver injury, declining hemoglobin levels in splenic injury, raised creatinine in renal injury, and elevated amylase and lipase in pancreatic injury. Non-operative management was successful in most hemodynamically stable patients, whereas operative intervention was required primarily in patients with persistent instability or failure of conservative management.

CONCLUSION

Blunt abdominal solid organ injuries are commonly managed successfully with non-operative strategies. The shock index is a useful predictor of injury severity, and combined clinical, biochemical, and radiological assessment aids in timely decision-making.