Burden of Emergency Exploratory Laparotomies: Sleepless Nights in Operation Rooms

Year 2019, , 1 - 6, 01.01.2019

Raheel Ahmad Muhammad Salman Shafique Syed Waqas Hassan Jahangir Sarwar Khan Sheikh Haseeb Ahmad Muhammad Umer Fayyaz Saqib Mehmood

https://doi.org/10.5455/umj.20190602085150

Abstract

Background: Recently the burden of emergency exploratory laparotomies has increased very rapidly. Both traumatic and non-traumatic abdominal emergencies are dealt with in surgical emergency departments which not only increase financial burden to health care setup but also a physical and psychological burden to healthcare providers. The purpose of this study was to share the burden and spectrum of these laparotomies in the emergency surgical department of a tertiary care hospital in a third world country. Materials and Methods: A retrospective observational study conducted at Surgical Unit-I, Holy Family Hospital, Rawalpindi, Pakistan from June 2014 to December 2016. All patients above 12 years presenting to our emergency department directly or referred from any other facility who underwent midline exploratory laparotomy in our hospital were included in our study. Results: A total of 433 patients were included in our study. Out of which, 254 58.66% were males and 179 41.33% were females and male to female ratio was 1.41:1.342 78.9% patients presented with non-traumatic cause whereas 91 21% patients have the history of abdominal trauma. Peritonitis 57.6% followed by intestinal obstruction 28.65% were the two most common indications of laparotomy in non-trauma patients whereas road traffic accidents and falls 65% were the most common cause of laparotomy in trauma patients. Intraoperative findings and operative management was compared between trauma and non-trauma patients. Conclusion: In resource-limited countries, they are posing a great burden to emergency departments of tertiary care hospitals. More specialized trauma centers should be established to cope with this burden.

Keywords

Emergency exploratory laparotomies, peritonitis, intestinal obstruction, road traffic accidents

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