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Reoperation after abdominal trauma.

T Driver, G L Kelly, B Eiseman

American Journal of Surgery

|June 1, 1978

Summary

This summary is machine-generated.

Unplanned reoperations after trauma laparotomy are often due to abscess or bleeding. Early suspicion and reexploration in trauma patients failing to recover can improve outcomes.

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Area of Science:

Trauma Surgery
Surgical Reexploration
Abdominal Surgery

Background:

Laparotomy is a common procedure for trauma patients.
Unplanned reoperations present unique challenges and risks.
Understanding indications for reexploration is crucial for patient management.

Purpose of the Study:

To analyze the indications for unplanned reoperations in trauma patients.
To evaluate the outcomes and mortality associated with repeat laparotomies.
To identify factors influencing the need for and success of reexploration.

Main Methods:

Retrospective review of 782 patients undergoing laparotomy for trauma over five years.
Specific analysis of 70 patients requiring unplanned reexploration.

Related Experiment Videos

Categorization of indications for reoperation and assessment of mortality rates.

Main Results:

Major indications for reexploration included intraabdominal abscess (45.7%), bleeding (15.5%), peritonitis (12.1%), and small bowel obstruction (8.6%).
Mortality in reexplored patients was 21.4%, with higher rates in those with gunshot or blunt trauma and multiple reoperations.
13.8% of reexplorations were negative.

Conclusions:

A high index of suspicion for hemorrhage or sepsis is necessary in trauma patients with delayed recovery post-laparotomy.
Early reexploration should be considered in patients not meeting expected convalescence norms.
Reexploration offers potential benefits outweighing risks for selected trauma patients.