Background: Blunt abdominal trauma (BAT) is a common and significant cause of morbidity and mortality, particularly in the context of motor vehicle accidents, falls, and assaults. The clinical presentation of BAT can be insidious; patients may initially appear stable only to deteriorate rapidly as internal bleeding or organ damage progresses. In the realm of diagnostic imaging, Computed Tomography (CT) has emerged as a pivotal tool in the assessment and management of BAT and is also instrumental in the ongoing assessment and monitoring of patients with BAT. Follow-up CT scans can be used to evaluate the progression or resolution of injuries, detect complications such as abscess formation or delayed hemorrhage, and guide subsequent management decisions.

Objectives: To assess the role of Computed Tomography (CT) as a primary diagnostic modality in the evaluation of blunt abdominal injury in hemodynamically stable patients, to determine the choice of management (operative versus conservative) by using the information provided from CT by grading the visceral injuries using the American Association for the Surgery of Trauma (AAST) classification and to compare intraoperative findings with CT findings by assessing the sensitivity and specificity of CT scan as a gold standard modality in blunt trauma.

Methods: A prospective study was conducted for a period of 2 years from September 2022 to August 2024, where we enrolled 50 patients presenting with a history of blunt abdominal injury Clinical and radiological data from patients with a history of blunt abdominal injury were recorded as per the pre-structured proforma. A computed tomography study using SIEMENS SOMATOM EMOTION (16 SLICE) was conducted. The data was collected and compiled in MS Excel and the significance level was fixed as 5% (α = 0.05).

Results: This study involved 50 participants, predominantly male (66%), with an age distribution mainly between 21-50 years. Road traffic accidents were the leading cause of injury (68%), followed by falls (16%). Abdominal pain was the most common initial symptom (50%), with hemoperitoneum present in 64% of cases and varying severities influencing management decisions. Visceral injuries, notably splenic (48%) and liver (28%), were common, with 74% of cases managed conservatively. Significant associations were found between the severity of injuries (liver, splenic, and kidney) and the chosen management approach. CT scans demonstrated high diagnostic accuracy for visceral injuries, surpassing EFAST in sensitivity and specificity.