Diagnostic Accuracy and Therapeutic Outcomes in Blunt Abdominal Trauma: Focus on Organ-Specific Injuries

Blunt abdominal trauma (BAT) poses significant diagnostic and therapeutic challenges, particularly in resource-limited settings. This study evaluated organ-specific injury patterns, diagnostic accuracy, and management outcomes in a high-volume Iraqi trauma center. A retrospective analysis of 280 BAT cases (2022–2023) was performed. Inclusion criteria were confirmed BAT via imaging (FAST, CT, or laparoscopy) or laparotomy. The data included demographics, injury mechanisms, AAST organ injury grades, management strategies (conservative vs. surgical), and outcomes (mortality and complications). Statistical analyses were performed using χ² and t-tests (SPSS v28). The cohort was predominantly male (72.5%), with RTAs causing 78.6% of the injuries. The liver (42.1%) and spleen (31.4%) were the most frequently injured organs; pancreatic injuries had the highest mortality (18.2%). The CT outperformed the FAST in terms of sensitivity (94.3% vs. 82.4%) and specificity (89.5% vs. 76.8%). Conservative management was successful in 84.4% of renal injuries but failed in 66.7% of pancreatic cases. Negative laparotomy was performed in 14.6% of surgeries. Delayed intervention (>6 h) resulted in tripled mortality rates (30.0% vs. 4.4%, p<0.01). BAT management requires organ-specific protocols, with CT being the cornerstone for diagnosis. Early intervention and judicious non-operative strategies for low-grade injuries can improve patient outcomes. These findings advocate strengthening the trauma system in comparable settings.