Article Figures & Data
Figures
- Figure 1
Patient flow chart.
Tables
- Table 1
Demographic summary of the included patients (n=594)
Frequency
(n=594)Percentage (%) Sex Female 214 36 Male 380 64 Ethnicity African American 44 7.4 Asian 32 5.4 Caucasian 270 45.5 Hispanic 229 38.6 Other 19 3.2 Glasgow Coma Scale 14 59 9.9 15 535 90.1 Self-reported abdominal pain No 434 73.1 Yes 160 26.9 Abdominal tenderness on examination No 380 64 Yes 214 36 CT scan findings Negative 462 77.8 Positive 132 22.2 Exploratory laparotomy No 559 94.1 Yes 35 5.9 Exploratory laparotomy findings Negative 6 17.1 Positive 29 82.9 Frequency missing=563 Abdominal pain or tenderness Negative self-reported abdominal pain and negative abdominal tenderness on physical examination 352 59.3 Negative self-reported abdominal pain and positive abdominal tenderness on physical examination 82 13.8 Positive self-reported abdominal pain and negative abdominal tenderness on physical examination 28 4.7 Positive self-reported abdominal pain and positive abdominal tenderness on physical examination 132 22.2 Injury severity score, median (Q1, Q3) 10 (7, 17) - Table 2
Factors associated with having abdominal pain findings
Abdominal pain or tenderness N Positive CT finding Had exploratory laparotomy Positive surgical finding N (%) p Value N (%) p Value N (%) p Value Self-reported abdominal pain No 434 75 (17.3) <0.001 9 (2.1) <0.001 8 (1.8) 0.1093 Yes 160 57 (35.6) 26 (16.3) 21 (13.1) Abdominal tenderness on physical examination No 380 54 (14.2) <0.001 4 (1.1) <0.001 4 (1.1) 0.0415 Yes 214 78 (36.5) 31 (14.5) 25 (11.7) Negative self-reported abdominal pain and negative abdominal tenderness on physical examination 352 50 (14.2) <0.001 4 (1.1) <0.001 4 (1.1) 0.0043 Negative self-reported abdominal pain and positive abdominal tenderness on physical examination 82 25 (30.5) 5 (6.1) 4 (4.9) Positive self-reported abdominal pain and negative abdominal tenderness on physical examination 28 4 (14.3) 0 (0) 0 (0) Positive self-reported abdominal pain and positive abdominal tenderness on physical examination 132 53 (40.2) 26 (19.7) 21 (15.9) *The corresponding p value was <0.05 among the four abdominal pain groups.
- Table 3
Surgical findings among the patients presenting without self-reported abdominal pain or abdominal tenderness on physical examination
ID Self-reported abdominal pain Abdominal tenderness on examination Mechanism of injury Intra-abdominal findings Time from arrival to surgical intervention (min) Outcome 1 No No Rollover MVA Grade 3 splenic laceration s/p exploratory laparotomy with splenectomy 99 Discharged home on day 6 2 No No MVA Grade 4 splenic laceration s/p exploratory laparotomy with splenectomy 151 Discharged home on day 13 3 No No MVA Grade 2 liver laceration, Grade 5 splenic laceration post s/p exploratory laparotomy with splenectomy 84 Discharged home on day 7 4 No No Rollover MVA Grade 4 splenic laceration s/p exploratory laparotomy with splenectomy 102 Discharged home on day 4. 5 No Yes Rollover MVA Extraperitoneal bladder rupture with intraperitoneal fluid s/p exploratory laparotomy with bladder repair 270 Discharged home on day 7 6 No Yes MVA Sigmoid mesenteric injury with arterial bleed s/p exploratory laparotomy with mesenteric vessel ligation 176 Discharged home on day 5 7 No Yes MCA Left colonic injury, left renal artery injury, and abdominal compartment syndrome s/p exploratory laparotomy with abdominal decompression and bogota bag placement 99 Discharged home on day 63 8 No Yes MVA Grade 4 splenic laceration, grade 1 left renal laceration s/p exploratory laparotomy with splenectomy and transverse colon resection 220 Discharged home on day 5 9 Yes Yes MVA Gangrene of the ileum, cecum, and sigmoid s/p exploratory laparotomy with ileal, cecal, sigmoidal resection 220 Deceased on hospital day 2 10 Yes Yes MCA Grade 4 splenic laceration s/p exploratory laparotomy with splenectomy 125 Discharged home on day 4 11 Yes Yes MCA Grade 4 splenic laceration s/p exploratory laparotomy with splenectomy 90 Discharged home on day 4 12 Yes Yes MCA Grade 3 splenic laceration s/p exploratory laparotomy with splenectomy 135 Discharged home on day 5 13 Yes Yes MVA Avulsion of the mesentery of the distal ileum, transverse colon, and sigmoid colon s/p exploratory laparotomy with resection of small bowel, sigmoid resection and primary anastomosis 125 Discharged home on day 5 14 Yes Yes MCA Grade 3 pancreatic tail laceration, grade 1 splenic laceration, grade 1 renal laceration s/p exploratory laparotomy with distal pancreatectomy and splenectomy 165 Discharged home on day 6 15 Yes Yes MVA Avulsion of the small bowel and sigmoid mesentery with mesenteric bleeding s/p exploratory laparotomy with sigmoidectomy, small bowel resection, and primary anastomosis 65 Transferred to outside facility on day 5 16 Yes Yes MVA Retroperitoneal hematoma s/p embolization by interventional radiology 340 Discharged home on day 3 17 Yes Yes MCA Left diaphragmatic rupture s/p exploratory laparotomy with diaphragmatic repair 61 Discharged home on day 18 18 Yes Yes Rollover MVA Small bowel perforation and grade 1 splenic laceration s/p exploratory laparotomy with small bowel resection and primary anastomosis 896 Discharged home on day 11 19 Yes Yes Rollover MVA Small bowel and mesenteric injury s/p exploratory laparotomy with small bowel resection and primary anastomosis 255 Discharged home on day 11 20 Yes Yes MVA Mesenteric avulsion of the distal ileum and ascending colon, deserosalization of the sigmoid colon, grade 1 liver laceration without active bleeding s/p exploratory laparotomy with right hemicolectomy and sigmoid colectomy 36 Transferred to outside facility on day 9 21 Yes Yes MVA Ruptured abdominal aortic aneurysm and ruptured iliac aneurysm s/p exploratory laparotomy with abdominal aortic aneurysm repair and left-sided aortoiliac anastomosis and right-sided aortofemoral anastomosis 164 Deceased on hospital day 2 22 Yes Yes MVA Right colon and mid-transverse colon necrotic and necrotic, non-perforated gallbladder s/p exploratory laparotomy with hemicolectomy and cholecystectomy 205 Discharged home on day 22 23 Yes Yes MVA Small bowel and right colon injury s/p exploratory laparotomy with small bowel resection and distal ileum to right colon resection with anastomosis 128 Discharged home on day 4 24 Yes Yes MCA Grade 4 splenic laceration s/p exploratory laparotomy with splenectomy 375 Transferred to outside facility on day 4 25 Yes Yes MVA Grade 5 splenic laceration s/p exploratory laparotomy with splenectomy 73 Discharged home on day 2 26 Yes Yes MVA Large jejunal mesenteric tear and ischemic small bowel s/p exploratory laparotomy with small bowel resection and primary anastomosis 274 Discharged home on day 4 27 Yes Yes MVA Mesenteric hematoma of the gastrocolic artery with no disruption s/p exploratory laparotomy with sigmoid colon colorrhaphy 175 Deceased on hospital day 13 28 Yes Yes MCA Grade 4 splenic laceration and grade 1 laceration of the left kidney s/p exploratory laparotomy with splenectomy 137 Discharged home on day 5 29 Yes Yes MVA Mesenteric tear at the transverse colon with active bleeding, mesenteric tear at ileocecal base, grade 1 liver laceration s/p exploratory laparotomy ligation of arteries 100 Discharged home on day 2 MCA, motorcycle accident; MVA, motor vehicle accident; s/p, status post.
Correlating abdominal pain and intra-abdominal injury in patients with blunt abdominal trauma
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