Spectrum of abdominal organ injury in a primary blast type

Study various abdominal organ injuries occurring in a primary type of blast injury.Material and methods: All those who had exploratory laparotomy for abdominal organ injuries after a primary blast injury for a period of 10 years from January 1998 - January 2008 were included in this retrospective study.Total 154 patients had laparotomy for abdominal organ injuries with a primary blast type of injury. Small intestine was damaged in 48 patients (31.1%) followed by spleen in 22.7% cases. 54 patients (35.06%) had more than one organ injured. Liver laceration was present in 30 patients (19.48%). Multiple small gut perforations were present in 37 patients (77.08%). Negative laparotomy was found in 5 patients (3.24%) whereas 3 (1.94%) had re-exploration. Mortality was present in 6 patients (3.89%).Primary blast injury causes varied abdominal organ injuries. Single or multiple organ damage can be there. Small intestine is commonest viscera injured. Laparotomy gives final diagnosis.Abdominal organs are always at risk for trauma in primary blast injury (PBI). These are notorious for inflicting multiple organ injury in abdomen. Most common abdominal viscera vulnerable to the PBI are those that containing the air. Proximity to site of blast wave, direction and intensity of primary blast wave (PBW), relative position of body and part of the abdomen struck by primary blast wave and the effect of various contents of abdomen and in the hollow viscera predict type and number of the abdominal organs injured. Clinical findings are varied and may be absent until the onset of complications. Tissue damage from the primary blast wave can be an important cause of occult trauma [1]. PBI may lead to bowel perforation, hemorrhage, mesenteric shear injuries, solid organ lacerations, and testicular rupture. A thorough clinical awareness of presentation of abdominal organ injuries, keen clinical observation complimented with X-ray and sonography abdomens are useful in diagnosis of PBI. These are