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Emergency laparotomy for abdominal trauma.

R D Sayers1, P C Bewes, K M Porter

  • 1Birmingham Accident Hospital, UK.

Injury
|January 1, 1992
PubMed
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Emergency laparotomy for intra-abdominal injuries, often caused by road traffic accidents, has a high mortality rate, particularly with liver injuries. The Injury Severity Score (ISS) can predict outcomes in these critical surgical cases.

Area of Science:

  • Trauma Surgery
  • Surgical Outcomes
  • Emergency Medicine

Background:

  • Emergency laparotomy is a critical procedure for diagnosing and managing intra-abdominal injuries.
  • Traumatic intra-abdominal injuries pose significant challenges in emergency surgical settings.

Purpose of the Study:

  • To review the experience of emergency laparotomies for suspected intra-abdominal injuries over a decade.
  • To identify common causes, indications, injured organs, and outcomes in patients undergoing emergency laparotomy.

Main Methods:

  • Retrospective review of 153 consecutive patients undergoing emergency laparotomy for suspected intra-abdominal injury.
  • Data collected included injury cause, operative indications, procedures performed (e.g., peritoneal lavage), organ injured, and patient outcomes (mortality, negative laparotomy rate).

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Main Results:

  • Road traffic accidents were the most common cause (61%).
  • Liver (34%) and splenic (30%) injuries were most frequent; liver injuries had a 52% mortality rate.
  • The overall mortality rate was 29%, with a 16% negative laparotomy rate.

Conclusions:

  • Emergency laparotomy for intra-abdominal trauma, especially from road traffic accidents, is associated with high mortality.
  • Higher Injury Severity Scores (ISS) were observed in non-survivors, indicating its prognostic value.