Clinical and anatomical features of blast injuries with leading damage to abdominal organs

BACKGROUND: A significant feature of military operations is the widespread use of unmanned aerial vehicles to carry explosive devices, ensuring their targeted delivery and impact at different levels of the human axial skeleton. This factor significantly impacts the anatomy and topography of blast injuries. This is evidenced by a greater diversity of injury patterns compared to previous scenarios, wherein contact mine (contact) blast injuries resulting in lower extremity damage were more prevalent. Consequently, investigating the injuring effects of abdominal blasts is of significant relevance.

AIM: The work aimed to determine the incidence of abdominal blast injuries and analyze their clinical and anatomical characteristics using available experimental findings on the mechanogenesis of this type of combat injury.

METHODS: The study focused on the clinical and anatomical characteristics of abdominal blast injuries. A comparative analysis of the clinical progression of traumatic syndrome and surgical outcomes between two patient groups was conducted. The main and control groups included 52 wounded patients with blast injuries and 65 patients with shrapnel wounds, respectively. The study groups were comparable in injury severity and baseline condition, with the abdomen being the primary localization of injuries in all cases.

RESULTS: Clinical and anatomical signs of primary blast injury effects were found in 10.3% of patients with abdominal shrapnel wounds. The study found that brisance and shock-wave injuries accounted for 46% of cases in the control group and 100% in the main group. The overall complication rate was 48.1% and 38.5% in the main and control groups (p > 0.05) respectively, with significant differences (p = 0.07) in Clavien–Dindo grades III–IV between the groups.

CONCLUSION: Primary blast injury effects have a significant negative impact on traumatic syndrome progression in patients with abdominal blast injuries. This includes a higher incidence of pulmonary and soft tissue infections and an increased risk of intestinal perforations caused by intestinal anastomotic leaks and acute ulcers.