Pattern of Fatal Thoraco Abdominal Injuries: An Autopsy Based Study at a Tertiary Care Centre in Jaipur

Abstract

Background: Thoraco-abdominal trauma may cause fatal internal haemorrhage and injury to multiple organs. Autopsy-based data on combined thoracic and abdominal injury patterns in Rajasthan are limited. This study aimed to describe external and internal injury patterns and the modes of injury among fatal thoraco-abdominal trauma cases. Materials and Methods: A prospective, hospital-based, cross-sectional observational study was conducted in the Department of Forensic Medicine and Toxicology, Sawai Man Singh Medical College, Jaipur. During one year of data collection, 150 eligible medicolegal autopsy cases were enrolled consecutively. Demographic characteristics, circumstances of injury, autopsy findings, survival interval and cause of death were recorded. Categorical variables were summarized as frequencies and percentages, and associations were assessed using the chi-square test, with p<0.05 considered significant. Results: Males constituted 82.0% of cases, and 59.3% were aged 21–40 years. Road traffic accidents accounted for 62.7% of cases. Abrasions were the most frequent external thoracic (63.3%) and abdominal (48.0%) injuries. Rib fractures occurred in 57.3%. The lungs (45.3%) and liver (54.0%) were the most frequently injured thoracic and abdominal organs, respectively. Combined thoraco-abdominal injuries occurred in 58.0%, and haemorrhagic shock accounted for 50.7% of deaths. Rib fractures were associated with lung injury and haemothorax, while liver injury was associated with haemoperitoneum (all p<0.001). Greater organ involvement was associated with haemorrhagic shock, and combined injuries were associated with shorter survival intervals. Conclusion: Fatal thoraco-abdominal trauma predominantly involved young adult males and resulted from road traffic accidents. Combined injuries and internal haemorrhage were common. Systematic autopsy examination is important for documenting organ injuries and determining the cause of death.

Keywords: Thoraco-abdominal trauma; medicolegal autopsy; road traffic accidents; haemorrhagic shock; organ injury.