Dynamic Cushioning: Obesity and Trauma Patients Undergoing Exploratory Laparotomy

2022 ◽  
Vol 270 ◽  
pp. 68-73
Author(s):  
Natalie Tully ◽  
Michelle Terry ◽  
Samudani Dhanasekara ◽  
Amber Tucker ◽  
Catherine Ronaghan ◽  
...  
Keyword(s):  
Exploratory Laparotomy ◽  
Trauma Patients

Intraperitoneal Urinary Bladder Rupture as a Cause of Pneumoperitoneum

2021 ◽  
pp. 000313482110257
Author(s):  
Dar Parvez M ◽  
Kour Supreet ◽  
Sharma Ajay ◽  
Kumar Subodh
Keyword(s):  
Urinary Bladder ◽  
Primary Repair ◽  
Exploratory Laparotomy ◽  
Pelvic Trauma ◽  
Bladder Rupture ◽  
Abdominal Pressure ◽  
Trauma Patients ◽  
Hollow Viscus ◽  
Sudden Rise ◽  
Intraperitoneal Bladder Rupture

The most common cause of pneumoperitoneum in trauma patients is hollow viscus injury; however, in patients with pneumoperitoneum on imaging and normal hollow viscus during the laparotomy, other rare causes of pneumoperitoneum like intraperitoneal urinary bladder rupture should be ruled out. Urinary bladder can rupture either extraperitoneally or intraperitoneally or both. Rupture of the urinary bladder is commonly seen in patients with abdominal trauma; however, pneumoperitoneum is usually not seen in patients with traumatic bladder rupture. Intraperitoneal bladder rupture is usually due to the sudden rise in intra-abdominal pressure following abdominal or pelvic trauma. However, it is a rare cause of pneumoperitoneum and is managed by surgical repair. We present a case of blunt trauma abdomen with pneumoperitoneum due to isolated intraperitoneal bladder rupture who was managed by exploratory laparotomy and primary repair of the urinary bladder.

Correlation between surgical site infection and obesity after exploratory laparotomy in trauma patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Abdelaziz ◽  
Ahmed Sabry ◽  
Mohamed Fayek
Keyword(s):  
Surgical Site Infection ◽  
Abdominal Trauma ◽  
Damage Control ◽  
Exploratory Laparotomy ◽  
Fascial Closure ◽  
Wound Complications ◽  
Trauma Patients ◽  
Obese Patients ◽  
Site Infection ◽  
University Hospitals

Abstract Background Obesity has become a major contributor to the global burden of chronic disease and disability. Understanding the effect of obesity on the incidence of wound infections and other wound complications remains incomplete despite considerable attention to both the growing ‘‘epidemic’’ of obesity and the frequent occurrence of surgical site infection (SSI) after surgical procedures. Damage-control laparotomy specifically has been associated with a higher rate of infectious complications and a lower rate of primary fascial closure in obese patients. Aim of the work The aim of the study is to evaluate the correlation between obesity and surgical site infection (SSI) in patients undergoing exploratory laparotomy after abdominal trauma. Patients and methods A retrospective study performed on obese patients of both genders aged between 18 and 60 years old undergoing exploratory laparotomy after abdominal trauma at the surgery departments of Ain Shams University Hospitals, Al-Bank Al-Ahly Hospital, Al-Mataria Hospital and Al-Salam Hospital, Cairo, Egypt for two years (1st of January 2018 to 1st of January 2020). Patients with infected wounds, receiving antibiotic therapy at the time of injury, those with a known immunodeficiency, who died within 48 hours after injury, who had sustained burn injuries, who underwent surgery at another institution before admission to our hospital were excluded. The rate of 30-day SSI post-operatively among obese and non-obese patients were compared. Statistical analysis was also done. Results Out of 782 patients, only 480 of those patients for whom BMI data were available, 360 (75%) were males and 120 (25%) were females. Out of the 480 patients: 168 patients had BMI more than 30; 114 patients (67.8%) had SSI (P < 0.05), 312 patients had BMI less than 30; 61 patients (19.5%) had SSI. All of the included patients were fulfilling the inclusion and the exclusion criteria. On multivariate analysis, obesity was the strongest predictor of SSI (odds ratio = 1.59; 95% confidence interval, 1.32-1.91) after adjustment for sex and age. Obese patients with SSI compared with the non-obese had longer hospital stays (mean, 9.5 vs 8.1 days, respectively; P < .001) and markedly higher rates of hospital readmission (27.1% vs 6.5%, respectively; P < .001). Conclusion Obesity is considered as one of the risk factors in causing surgical site infection. Thus, this study showed the relation of BMI and obesity with surgical site infection in case of exploratory laparotomy after abdominal trauma.

The Utility of Sonography for the Triage of Blunt Abdominal Trauma Patients to Exploratory Laparotomy

2007 ◽  
Vol 188 (2) ◽  
pp. 415-421 ◽  
Author(s):  
Brett C. Lee ◽  
Eleanor L. Ormsby ◽  
John P. McGahan ◽  
Giselle M. Melendres ◽  
John R. Richards
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Exploratory Laparotomy ◽  
Trauma Patients

Diagnostic Laparoscopy Reduces the Rate of Negative Laparotomy in Trauma Patients

2020 ◽  
Vol 22 (1) ◽  
pp. 47-51
Author(s):  
Debashish Bar ◽  
Masrur Akbar Khan ◽  
Sanjana Sharmin Shashi ◽  
AZM Mahfuzur Rahman ◽  
ABM Khurshid Alam ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Diagnostic Laparoscopy ◽  
Exploratory Laparotomy ◽  
Operative Management ◽  
Bowel Injury ◽  
Trauma Patients ◽  
Abdominal Injuries ◽  
College Hospital ◽  
Negative Laparotomy ◽  
Intraabdominal Injuries

Background: The last century has witnessed immense evolvement of management of patients with abdominal trauma. Moreover the recent trend has shifted to selective operative management rather than exploratory laparotomy in trauma patients with suspected intraabdominal injuries and is considered more rational as well. Diagnostic laparoscopy is highly sensitive in detecting intra-abdominal injury with subsequent reduction in the rate of negative laparotomy and procedure related morbidity. Objective: The study was carried out to find the role of diagnostic laparoscopy in abdominal trauma. Methods: An observational study was carried out in the casualty block of Dhaka Medical College Hospital from 1st June 2015 to 30th March 2016. A total of 50 successive patients were assigned in this study. All of them were admitted with abdominal trauma and underwent diagnostic laparoscopy during the period of 10 months. The study was designed to find out whether laparoscopy can help in identifying intra-abdominal injuries with consequent avoidance of unnecessary operative explorations. Results: Intra-abdominal injuries other than GIT perforation were diagnosed by laparoscopy with 100% accuracy but in case of bowel injury the diagnostic accuracy was 80%. Conclusion: Diagnostic laparoscopy is the procedure of choice in doubtful intra-abdominal injuries with impressive accuracy except for bowel injury. Subsequently it reduced the need for negative laparotomies with their procedure related adverse effects. Journal of Surgical Sciences (2018) Vol. 22 (1): 47-51

Predictors of Acute Kidney Injury after Exploratory Laparotomy in Trauma Patients

2017 ◽  
Vol 225 (4) ◽  
pp. e184
Author(s):  
Tianyi Swartz ◽  
Andrew L. Tang ◽  
Faisal Jehan ◽  
Fahad S. Ahmed ◽  
Arpana Jain ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Exploratory Laparotomy ◽  
Trauma Patients

scholarly journals The role of laparoscopy in patients with abdominal trauma

2019 ◽  
Vol 7 (5) ◽  
pp. 1853
Author(s):  
Pranav K. Sharma ◽  
Gaurav Gupta
Keyword(s):  
Blunt Trauma ◽  
Abdominal Trauma ◽  
Case Reports ◽  
Operating Time ◽  
Penetrating Trauma ◽  
Exploratory Laparotomy ◽  
Therapeutic Interventions ◽  
Trauma Patients ◽  
Diagnostic Dilemma ◽  
Therapeutic Laparoscopy

Background: Use of laparoscopy in penetrating trauma has been well established; however, its application in blunt trauma is gaining popularity as a useful diagnostic tool to avoid unnecessary laparotomies where there is diagnostic dilemma. Even though recent case reports seem to suggest that these patients can be managed using laparoscopy, the practice is not yet wildly adopted.Methods: All adult patients who presented with abdominal trauma laparoscopic surgery was considered in patients who were deemed fit for the same in the Department of General Surgery, MMIMSR, Mullana, Ambala during a period of 18 months starting from January 1st 2015 to June 30th 2016. Data was analysed using descriptive statistics.Results: A total of 53 patients with either blunt or penetrating abdominal trauma that required surgery were included in the study. Exploratory laparotomy was performed in 45 patients (84.91%) and laparoscopy was performed in 8 patients (15.09%). Overall mesenteric injury (45.28%) was the most common intra-abdominal injury noted. The most common organ involved in blunt trauma was the spleen (68.97%). The mean operating time of laparoscopy was lesser by 57 minutes as compared to exploratory laparotomy. The use of laparoscopy avoided negative and non-therapeutic laparotomy in 2 patients (25%). Therapeutic laparoscopy was performed in 3 patients with repair of bowel and mesenteric injuries. There was no documented procedure‑related morbidity and mortality.Conclusions: The positive outcomes from the study suggest that laparoscopy can be safe and feasible in both diagnostic and therapeutic interventions in carefully selected blunt abdominal trauma patients.

scholarly journals Pattern of injuries in trauma patients presenting in Accident and Emergency Department of Jinnah Hospital, Lahore

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Kamran Ali ◽  
Ghulam Mustafa Arain ◽  
Ahmad Sohail Masood ◽  
Aslam M
Keyword(s):  
Emergency Department ◽  
Upper Limb ◽  
Lower Limb ◽  
Tertiary Care ◽  
Age Groups ◽  
Exploratory Laparotomy ◽  
The Body ◽  
Trauma Patients ◽  
Accident And Emergency ◽  
Accident And Emergency Department

Objective: To observe the pattern of injuries in patients involved in different kinds of trauma presenting to the Accident and Emergency Department of Jinnah Hospital Lahore. Design: A prospective descriptive epidemiological study. Place and duration of study: Accident and emergency department of Jinnah Hospital Lahore. From 1st April 2005 to 30th September 2005. Subjects and methods: The study included patients presenting with different kinds of trauma to the emergency department of Jinnah Hospital, Lahore. They were further categorized into trauma of different regions of the body i.e. upper limb, lower limb, abdomen, head & neck, thorax and perineum. Then frequency of different types of trauma was determined. Results: During this period (1st April2005 to 30th September 2005), 111`413 patients presented in accident and emergency department and 4680 patients had traumatic injury. 1404 patients (30%) had blunt trauma, 134(2.86%) had penetrating firearms injury, 2433(51.99%) had penetrating sharp injury an d 709 patients (15.15%) had crush injury. Most patients got upper limb, lower limb, head & neck and abdominal injuries, in that order. Most patients received multiple injuries. 3340 patients (71.36%) got only minor surgery like stitching under local anaesthesia and 468 patients (10%) had no surgery at all. 872 patients (18.63%) underwent some kind of major surgical procedure like amputation, exploratory laparotomy, or stitching under GA etc. Conclusion: Trauma is a leading cause of morbidity and mortality among all age groups. Most of the trauma victims receiving minor injuries can be treated at primary heath care centers. This can decrease the load of tertiary care hospitals. Maximum impact in reducing the burden of trauma must come from injury prevention strategies.

scholarly journals A Descriptive Study on the Usage of Exploratory Laparotomy for Trauma Patients

2020 ◽  
Vol Volume 12 ◽  
pp. 255-260 ◽  
Author(s):  
Ali Pooria ◽  
Afsoun Pourya ◽  
Alireza Gheini
Keyword(s):  
Exploratory Laparotomy ◽  
Descriptive Study ◽  
Trauma Patients

Successful anesthetic management in a case of grade V splenic injury in covid 19 positive patient: A case report

2021 ◽  
Vol 8 (4) ◽  
pp. 49-53
Author(s):  
Anupama Kumari ◽  
Farah Husain ◽  
Anjili Sethi ◽  
Kirti Nath Saxena
Keyword(s):  
Case Report ◽  
Splenic Injury ◽  
Anesthetic Management ◽  
Exploratory Laparotomy ◽  
Anaesthetic Management ◽  
The Body ◽  
Splenic Trauma ◽  
Trauma Patients ◽  
Emergency Unit ◽  
Antigen Test

Splenic injuries are amongst the most frequent trauma-related injuries which requires emergency surgeries demanding meticulous surgical and anesthetic management. The aim while managing splenic trauma patients, is to restore homeostasis and normal pathophysiology in the body by achieving hemostasis with an emergency splenectomy. To date, there have been few reports describing the anaesthetic management of COVID-19 patients presenting for emergency surgery. In this article, we outline the anaesthetic management for a case with hemoperitoneum, posted for emergency exploratory laparotomy and splenectomy in our operating theatre who was incidentally diagnosed to be COVID positive in the emergency unit by a rapid antigen test.

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