Objectives Due to lack of sufficient data it is difficult to understand fully the pattern of abdominal injury after an earthquake. This study aimed to evaluate the pattern of abdominal injury by analysing the data of trauma patients with abdominal injury incurred during the 2008 Wenchuan earthquake.

Methods We retrospectively reviewed the medical records of 37 387 inpatients. Among them, 883 (2.36%) cases of abdominal injury were deemed eligible and enrolled for analysis. The data analysed included demographics, category of abdominal injury, associated injury type, cause of injury, treatment and clinical outcome, as well as risk factors for death.

Results Abdominal injury was often accompanied with multiple injuries. Injury of the abdominal wall was the most frequent type of earthquake-related abdominal injury (32%). The spleen was the most commonly injured abdominal organ (18%). Of the 883 patients evaluated, 221 cases received operations and 41 cases died. The highest death rate was found in patients with haemorrhagic shock (28/41, 68.3%) caused by intra-abdominal bleeding.

Conclusions Abdominal injuries are relatively uncommon in earthquake disasters and often present with associated injuries. A timely and complete diagnosis of both abdominal as well as associated injuries is of primary importance in the treatment of patients with abdominal injuries. Knowledge of different types of abdominal injury, and their relative proportions, prevalence of associated injuries, risk factors and final clinical outcomes observed in this study may be of valuable reference in dealing with major earthquake events in the future.