Introduction
Trauma represents a major cause of death in patients presenting in Emergency 
Department .Abdomen represents a commonly injured region which may often by 
missed in cases of blunt trauma particularly when compounded with other obvious 
musculoskeletal injuries. The role of trauma team is to assess, resuscitate and man
age all poly-trauma patients in a systematic manner to avoid missing intra-abdomi
nal injuries and manage such patients aggressively.
Materials and Methods
This retrospective study was conducted in Liaquat National Hospital, Karachi 
which is a level 2 Trauma centre. All the data was obtained from the hospital’s reg
istry for the period of 1 year from January 2014 to December 2014. Trauma victims 
who fulfilled Trauma team activation criteria were included in study with following 
criteria. Inclusion - 1 – Patients with abdominal trauma with obvious penetrating 
injury either in the form of gunshot injury, stab wound or any object penetrating 
the abdomen with or without an exit wound. 2 - Patients with blunt trauma with 
Ultrasound Fast/ CT scan showing free fluid, hemoperitoneum or visceral injury. 3 – 
Adult patients more than 18 years of age. 4 – Poly trauma patients with associated 
abdominal injury. Patients excluded from study were 1 – Trauma patients less than 
18 years of age. 2 – Poly trauma patients who had no abdominal injury. 3 – Pa
tients who expired with 10 minutes of presentation within Emergency Department 
or brought Dead. 
Results
A total of 150 trauma calls were generated during the year 2014. Out of these 
150 trauma calls, 25 (16.6%) patients met the inclusion criteria of having intra-ab
dominal injury. Male to Female Ratio was 24:1. Among the patients who sustained 
abdominal injuries, 9 (26%) patients had blunt trauma to abdomen while 16 (64%) 
patients had penetrating abdominal injuries. In penetrating Injuries, 15 (60%) cases 
were due to gunshot injuries while 1 (4%) was due to an assault. 16 (64%) patients 
required immediate laparotomy. 15 of these patients had penetrating injuries and 1 
had blunt trauma, 8 patients were managed conservatively and 1 patient underwent 
Angio-embolization of splenic artery. Time required to shift patient from ER to OT 
was variable between 36 minutes to 69 minutes with a mean value of 50 minutes. 
Patients who were managed conservatively had an ED stay time varying from 40 
minutes to 160 minutes with Mean value of 130 minutes. Of 25 patients who had 
abdominal injuries, 21 (84%) patients survived and 4 (16%) patients expired. Among 
the patients who went immediate surgical intervention, 3 patients expired. And 1 
patient who underwent Angioembolization of splenic artery expired. 
Conclusion
 Because of the concealed nature of intra-abdominal hemorrhage, one is likely 
to miss abdomen as a potential source of bleeding until patient decompensates to 
unresuscitable state of shock. Thus, appropriate management of severe trauma pa
tients can only be achieved by a systematic evaluation by Trauma team according 
to ATLS guidelines. Our study concluded that the time factor for activation of trauma 
team and shifting of patient was not the major factor among patients who expired. 
Although the shifting time was fairly long for patients who were managed conserva
tively, it was not identified as a cause of death