Background: Symptoms of BLUNT ABDOMINAL TRAUMA and the related diagnostic methods are of great importance.Objective: To evaluate BLUNT ABDOMINAL TRAUMA in Shahid Rajaee hospital of Qazvin.Methods: Through a retrospective study, 313 patients with BLUNT ABDOMINAL TRAUMA out of 1017 TRAUMAtic cases, who referred to Shahid Rajaee hospital from 1993 to 1996, were selected.Findings: The findings indicated that the most common involved organs were spleen, liver, small bower, kidney and uraters respectively. The most common signs in alert patients were pain, drop of blood pressure and sign of peritonitis. More admissions happened in summer especially in the month of Shahrivar, and more in males than females with the rate of 4 to 1. There were 87.9% discharged cases and 9.9% mortality cases. 47% of the cases had splenic TRAUMA, 25.5% liver TRAUMA and 14.3% small bowel TRAUMA.Conclusion: Different results especially in U.S.A. are probably due to fastening the seat belts while driving which results in more bowel TRAUMA and less liver TRAUMA.

Appendecitis is one of the most frequent surgeries. Inflammation of appendix may be due to variable causes such as fecalit, hypertrophy of Peyer’s plaques, seeds of fruits and parasites. In this study we presented an uncommon type of appendicitis which occurred after ABDOMINAL BLUNT TRAUMA.In this article three children present who involved acute appendicitis after BLUNT ABDOMINAL TRAUMA. These patients were 2 boys (5 and 6-year-old) and one girl (8-year-old) who after BLUNT ABDOMINAL TRAUMA admitted to the hospital with ABDOMINAL pain and symptoms of acute abdomen and appendectomy had been done for them.TRAUMA can induce intramural hematoma at appendix process and may cause appendicitis. Therefore, physicians should be aware of appendicitis after BLUNT ABDOMINAL TRAUMA.

TRAUMAtic ABDOMINAL wall hernia is a rare type of hernia, which follows BLUNT TRAUMA to the abdomen, where disruption of the musculature and fascia occurs with the overlying skin remaining intact. Diagnosis of this problem is very difficult and delayed.TRAUMAtic hernia is often diagnosed during laparatomy or laparascopy, but CT scan also has a role in distinguishing this pathology. Delay in diagnosis is very dangerous and can result in gangrene and necrosis of the organs in the hernia. The case report of a 35 years old man with liftruck BLUNT TRAUMA is reported. His vital signs were stable. On physical examination, tenderness of RUQ was seen. He underwent Dpl for suspected hemoprotein. Dpl was followed up by laparatomy. Laparatomy revealed that the transverse and ascending colon partially herniated in the ABDOMINAL wall defect. The colon was reduced in the abdomen and repair of ABDOMINAL hernia was done. The patient was discharged after 5 day. The etiology, pathogenesis and management are discussed.

Rupture of a hydatid cyst can lead to the development of a disseminated form of intra-ABDOMINAL cystic echinococcosis if not diagnosed and treated promptly. Anaphylactic shock is a definite indication of cyst rupture. The presented clinical case was a young athlete with a disseminated form of cystic echinococcosis, which was investigated in 2023 at the Syzganov National Scientific Center for Surgery of Kazakhstan. The disease developed gradually following a sports injury to the abdomen during sports training and was accompanied by blurred signs of anaphylactic shock. In the next 2 years, echinococcosis of the ABDOMINAL cavity was asymptomatic. The clinical manifestation of cystic echinococcosis developed gradually over the last 10-12 weeks, in the form of dull, painful ABDOMINAL pain, malaise, weakness, sweating, nausea, poor appetite, and weight loss. Subacute manifestations of the disease resembled those of acute appendicitis. A diagnostic laparotomy revealed an abundance of cystic formations in the ABDOMINAL cavity, necessitating a differential diagnosis between a disseminated form of ABDOMINAL tuberculosis with damage to the mesenteric lymph nodes. However, instrumental verification of the parasite, together with the morphological exclusion of the extrapulmonary form of tuberculosis, made it possible to establish a disseminated form of cystic echinococcosis. The patient underwent a cystectomy, was discharged in satisfactory condition, and was informed about the possibility of disease recurrence. In conclusion, in hyperendemic zones, it is recommended to carry out immunological testing for echinococcosis on all ABDOMINAL sports injuries, independent of the presence of anaphylactic shock symptoms.

Background and Objectives: The purpose of this study was to determine the criteria which define the low risk patients after BLUNT ABDOMINAL TRAUMA. It may hasten the patients handing and avoid unnecessary imaging and diagnostic. Considerations in low risk conditions.Materials and Methods: All adult patients referred to Imam Hussein hospital emergency department with BLUNT ABDOMINAL TRAUMA and had signs and symptoms of intra-ABDOMINAL injury were enrolled to the study and followed for one-month. Collected data analyzed with Chi-square test. Sensitivity, specificity, positive and negative predictive value of each factor was calculated.Results: From total number of 205 enrolled patients (80% were male and 20% were female). The prevalence of three clinical factors (including’s hematuria, shock index above 0.8) and more clinical signs and symptoms at presentation were higher in patient with Intra-ABDOMINAL visceral injury than discharged patients (P<0.0001). Sensitivity, specificity, positive predictive value and negative predictive value of serious clinical presentation, hematuria, and shock index above 0.8 in the diagnosis of ABDOMINAL visceral injury were 100%, 45%, 100% and 17% respectively.Conclusion: This study showed that patients with low-risk criteria in BLUNT ABDOMINAL injury can be discharged without an abdominopelvic CT scan.

Background & Objective: Patients in unstable clinical conditions with BLUNT ABDOMINAL TRAUMA require rapid evaluation of the ABDOMINAL organ injury to assess the need for laparatomy. This prospective study was conducted to determine the use of emergency sonography for evaluating patients with BLUNT ABDOMINAL TRAUMA and to compare the accuracy of sonography with the results of diagnostic peritoneal lavage (DPL), exploratory laparatomy and CT scan. Patients and Methods: Emergency sonography was performed prior to any of the diagnostic methods, peritoneal lavage, exploratory laparatomy and CT, on 204 patients with BLUNT ABDOMINAL TRAUMA. Sonography was performed with the "focused ABDOMINAL sonography for TRAUMA" (FAST) technique and six areas of the abdomen were examined to detect free peritoneal fluid. Results: Sonography showed a sensitivity of 95.4%, specificity of 78.4% and an overall accuracy of 89% in the diagnosis of free peritoneal fluid. The positive and negative predictive values of sonography were 89.2% and 90.6%, respectively. Conclusion: Sonography is a reliable and accurate method for the emergency evaluation of BLUNT ABDOMINAL TRAUMA.

Duodenal rupture followed by BLUNT TRAUMA is usually very rare and happens by hit to epigastrium region caused by TRAUMA, accident or sport injuries. Because of unclear signs or no specific signs of rupture, usually diagnosis of rupture is delayed and associated with dangerous or occasionally deathful complications. The patient was a 29-year-old male who three days after accident referred to emergency unit of Shahroud Imam Hossein hospital with severe pain of abdomen, nausea, decrease in level of consciousness and unstable vital signs. After resuscitation, the patient with diagnosis of peritonitis underwent laparotomy. He had transverse and severs rupture that after duodenal reconstruction, a jejunostomy was performed, then a drain was placed at the site of duodenum and pancreas and the patient was sent to ICU. After two days followed by leakage from ABDOMINAL drain, the patient underwent laparotomy again. Then after one week, followed by leakage from ABDOMINAL drain, the patient underwent laparotomy. One week after last operation, due to general condition improvement, the patient was transferred to surgical ward and jejunostomy feeding was started for him and duodenostomy and jejunostomy were excluded. Then with enough speed, and paying attention to clinical signs & symptoms and with patient's exact examination, it is possible to prevent the waste of time and expense and gain desired results of treatment.

Background: Ultrasound has widely been used to assess patients with BLUNT ABDOMINAL TRAUMA and detect free fluid in the abdomen. Nevertheless, different studies reported different false negative for this imaging technique. Objectives: The present study was conducted to evaluate the diagnostic value of the repetitive ultrasound in diagnosis of free intraperitoneal fluid. Methods: In this study, 125 patients with ABDOMINAL BLUNT TRAUMA were recruited prospectively for ultrasound evaluation. Ultrasound and CT-scan were performed for all recruited patients in the study. In case of positive ultrasound or CT-scan (free fluid in the peritoneal cavity), patients underwent surgical operation. In the presence of negative ultrasound and CT-scan, and if the patient was alert and had stable vital signs, then, he/she would undergo exact supervision. In such patients, ultrasound and CT-scan were repeated 12 and 24 hours after admission. If any of the tests were positive, the patient underwent laparotomy. Moreover, if ultrasound and CT-scan examinations were negative 24 hours after admission, the patients with normal laboratory tests were discharged according to the surgeon’ s decision. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Results: Of the 125 patients with ABDOMINAL BLUNT TRAUMA, 90patients finally underwent laparotomy. Basedonthe surgicaloutcome as the gold standard, the initial, 12 hours, and 24 hours sensitivity were measured to be 19. 8%, 75. 2%, and 82. 2%, respectively. These numbers for specificity were 91. 7, 75, and 70. 8, respectively; they were 90. 9, 92. 6, and 92. 2 for PPV, and 21. 3, 41. 8, and 48. 5 for NPV, respectively. Conclusions: The sensitivity of ultrasound to detect intraperitoneal fluid in BLUNT ABDOMINAL TRAUMA cases will be increased by repeated ultrasound examinations.

Introduction: The possibility of intestinal injury for all patients presenting to emergency department (ED) with BLUNT ABDOMINAL TRAUMA, despite minimal physical signs should be considered. To highlight the patient management, hear, we report a case of hollow viscus injuries resulting from BLUNT ABDOMINAL TRAUMA referring to a teaching hospital in Tehran, Iran.Case presentation: A 30-year-old man presented to the ED after "falling into a hole" with his back and had direct BLUNT ABDOMINAL TRAUMA by a heavy bag of cement. In physical examination, there was a mild ABDOMINAL tenderness on right upper quadrant. On bedside ultrasonography, there was small free fluid in his Morison’s pouch without hypotension. So ABDOMINAL CT scan was performed which revealed free fluid in pelvic, perihepatic, and perisplenic spaces. Mural hematoma of proximal part of jejunum with mural wall hypodensity in mid jejunal loop were also revealed. The patient underwent surgery, and there was damage to the colon serosa and jejunal perforation which was primarily repaired.Conclusion: The presented case highlights the importance of obtaining history and physical exam and paying attention to the nature and mechanism of injury. Emergency physicians should be aware of hollow viscus injury in TRAUMAtic patients. Any delay in diagnosis and operative management are associated with an increase in mortality.

Aims: Focused Assessment with Sonography for TRAUMA (FAST) is used as a screening tool to detect hemoperitoneum in patients with BLUNT ABDOMINAL injuries in many TRAUMA centers all over the world. However, Iranian TRAUMA centers are unaccustomed to performing it as a routine. The aim of this study was to evaluate the sensitivity and specificity of FAST performed by surgeons and to announce its advantages to Iranian surgeons Materials & Methods: Data were collected prospectively in one hundred BLUNT ABDOMINAL TRAUMA patients admitted to Baqyiatallah Hospital from April 2008- April 2009. FAST was used by surgeons or senior surgical residents to detect intra peritoneal fluid and considered positive if such fluid was identified. Data were analyzed using SPSS14.Results: 5 of the 100 patients had proven intra ABDOMINAL injuries and 95 had no injuries. FAST result was positive in 7 patients and negative in 93 patients. There were 2 false positive results. The sensitivity and specificity of FAST were 100% and 97.8%, respectively. The positive predictive value was 71.4%, the negative predictive value was 100% and the accuracy was 98%.Conclusion: Focused Assessment with Sonography for TRAUMA which is performed by general surgeons, can detect the presence or absence of intra peritoneal fluid rapidly and accurately. FAST is a potentially valuable tool for better management of TRAUMA patients.