Relaparotomies in Abdominal Trauma, Systematic Review
Iraqi Postgraduate Medical Journal,
2015, Volume 14, Issue 1, Pages 123-130
Treatment of a number of complications that occur after abdominal trauma surgeries may require that Urgent Abdominal Re-explorations, the life-saving and obligatory operations, are performed.
To evaluate the reasons and incidence of re-operations in abdominal trauma cases and their outcomes in our centre, so that more preventable morbidity can be avoided.
A retrospective study of all trauma victims who sustained laparatomies and relaparatomies in the Emergency Department of Al-Imamain Al-kadhymain Medical City, Baghdad, over a 2 years period. A review of the case sheets of these victims has been reviewed to identify the various circumstances of trauma cases and the detailed operative findings and definitive causes of relaparatomies were noted.
The study included 21 relaparatomy cases out of 244 laparatomy for various abdominal trauma reasons ; 180 patients (74%) males and 64 (26%) females, with a male to female ratio of about (3:1). The commonest causative accidents were missile inury 97pt (39%), gunshot injuries 58 (24%), road traffic accidents 43pt (18%), stab wound 32 pt(13%), and. Fall from height 14 pts (6%) . Reoperations were performed in 21 cases Incidence (8.6%), finding in reoperation including second look operation (which constituted 4 patients) were as the followings:
Bleeding 11 pts ( 52%), peritonitis from missed bowel injuries & anastomosis leak 5 pts (24% ), small bowel obstruction one pt (5%), IAC(abscess) 2pt (9.5%) and prolonged ileus & peritonism 2 Pts (9.5%).
Overall mortality in the reexplored patients was 8 patients(38%). Incidence of missed injuries 24% of reoperation and 1.6% of total trauma cases.
many pt can be saved from repeat laparatomy by avoiding missed injuries. The main reason for immediate reoperation is bleeding and lately is peritonitis and sepsis.
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