Patterns of Computed Tomography Findings in Patients With Blunt Abdominal Trauma at the Kenyatta National Hospital

Abstract

Background: Trauma is ranked among the leading causes of mortality globally among all age groups with abdominal trauma making up 10% of these. In Kenya abdominal trauma accounts for a huge proportion of patients referred to Kenyatta National Hospital (KNH). Clinicians cannot rely on physical examination as an accurate assessment for patients with blunt abdominal trauma (BAT) consequently, they rely on a number of diagnostic imaging modalities for evaluation of patients. Ultrasonography (US) is a readily available imaging modality for investigating patients with suspected BAT but on the flip side it is not adequate for assessment of retroperitoneal organs. Computed tomography (CT) is not only fast but also the preferred imaging modality in a stable patients with BAT. It has been shown to reliably outline the patterns, severity and extent of injuries to both peritoneal and retroperitoneal organs. Injury patterns among patients with abdominal trauma has been shown to vary between developing versus developed countries. Over the last few years developed countries have noted a rise in cases of penetrating injuries. This was likened to increase in gun violence, civil violence and criminal activities. Blunt abdominal trauma has been shown to dominate in developing countries and various authors postulated that this could be due to mechanisms of injury such as direct blow to the abdomen, impact on an object, a fall from a height, motor bike injuries and motor vehicles accidents (MVA). Knowledge of patterns of injury and their grading informs aspects of management such as availing necessary equipment at trauma centres, encouraging training of the much needed personnel and continuous medical education to health care workers at the trauma centres.................................................................................