Introduction: Following injuries to the extremities and head, the abdomen is the third most commonly injured part of the body. Blunt abdominal trauma is one of the most common causes of morbidity and mortality among younger age groups. Here we study the clinical abdominal scoring system (CASS) in predicting the necessity of laparotomy in blunt abdominal trauma in the era of modern imaging modality.
Methods: 100 patients with blunt abdominal trauma were included in this study at SMS Medical College Jaipur over a period of six months (July 21 to Dec 21). Data were collected about incidence history, medical history, demographics, clinical examination, diagnostic and imaging tests, management, and outcome.
Results: On admission for all 100 patients, CASS was calculated. 29 patients fall into the low-risk group (12 CASS) planned to be managed with immediate laparotomies (12 improved, 2 died). 57 patients falling into the intermediate risk group (9–11 CASS) were followed by repeated clinical examination and modern imaging modality, i.e., a CT scan. 17 patients (out of 57~29%) were managed with laparotomies (15 improved, 2 died), and 40 patients (out of 57~71%) were managed conservatively (all improved).
Conclusion: CASS is promising in early detection of the need for laparotomies in BAT patients; in equivocal results (intermediate risk group CASS) CT findings are useful for decision-making about surgical vs. conservative management approaches.
Key words: Trauma, CASS, Blunt abdominal trauma, laparotomy
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