The use of laparoscopy in the diagnosis and treatment of blunt and penetrating abdominal injuries: 10-year experience at a level 1 trauma center.

Abstract

BACKGROUND:

Diagnostic laparoscopy (DL) has decreased the rate of nontherapeutic laparotomy for patients suffering from penetrating injuries. We evaluated whether DL similarly lowers the rate of nontherapeutic laparotomy for patients with blunt injuries.

METHODS:

All patients undergoing DL over a 10-year period (ie, 2001-2010) in a single level 1 trauma center were classified by the mechanism of injury. Demographic and perioperative data were compared using the Student t and Fisher exact tests.

RESULTS:

There were 131 patients included, 22 of whom sustained blunt injuries. Patients suffering from blunt injuries were more severely injured (Injury Severity Score 18.0 vs 7.3, P = .0001). The most common indication for DL after blunt injury was a computed tomographic scan concerning for bowel injury (59.1%). The rate of nontherapeutic laparotomy for patients sustaining penetrating vs blunt injury was 1.8% and nil, respectively.

CONCLUSIONS:

DL, when coupled with computed tomographic findings, is an effective tool for the initial management of patients with blunt injuries.

• Authors: Jeremy J Johnson, Tabitha Garwe, Alexander R Raines, Joseph B Thurman, Sandra Carter, Jeffrey S Bender, Roxie M Albrecht
• Journal: American journal of surgery (Am J Surg) Vol. 205 Issue 3 Pg. 317-20; discussion 321 (Mar 2013) ISSN: 1879-1883 [Electronic] United States
• PMID: 23375706 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Topics

• Abdominal Injuries (classification, diagnosis, surgery)
• Adult
• Female
• Humans
• Injury Severity Score
• Laparoscopy (statistics & numerical data)
• Male
• Oklahoma
• Retrospective Studies
• Tomography, X-Ray Computed
• Trauma Centers
• Treatment Outcome
• Wounds, Nonpenetrating (diagnosis, surgery)
• Wounds, Penetrating (diagnosis, surgery)