Abstract

Introduction: Abdominal trauma presents with a significant percentage of emergency department presentations and high morbidity and mortality. Diagnostic complexity, limited resources, and the prevalence of common polytrauma often hinder effective management.

Objective: To evaluate the epidemiology, treatment pattern, and systemic problems of abdominal trauma management in a high-volume trauma center.

Materials and Methods: It was a retrospective study of trauma admissions to a tertiary trauma center. Data gathered included demographic characteristics, injury patterns, diagnostic and treatment algorithms, and utilization of institutional services. Blunt and penetrating abdominal trauma were both assessed with particular emphasis on concomitant injuries and operation challenges.

Results: Over 2 years, January 1, 2021 - December 31, 2022, of 32,037 emergency department admissions, 22,875 (71.4%) were trauma cases. Of these, 2,745 patients (12%) had an Injury Severity Score (ISS) greater than 15. Abdominal trauma was diagnosed in 5,032 cases (22%), the majority (78%) of which were blunt (3,655 cases), in contrast to 1,377 cases (22%) of penetrating injuries. 27.4% and 30.5% of trauma patients presented with associated chest and head injuries, respectively. The primary management challenges were rapid trauma diagnosis in polytrauma, restricted surgical and ICU facilities, injury prioritization, optimal patient flow, multidisciplinary coordination, and sustaining care standards in high volume.

Conclusion: High-volume trauma centers are challenged by abdominal trauma management due to diagnostic complexity and high polytrauma rates. Blunt trauma is common, with the need for sophisticated imaging and selective non-operative interventions. Standardized triage, ongoing multidisciplinary care, and effective resource planning are all necessary for optimal outcomes.

Keywords: Abdominal trauma, polytrauma, blunt trauma, penetrating trauma, trauma systems, emergency surgery, injury severity score