What is trauma laparotomy?

What is trauma laparotomy?

A typical trauma laparotomy includes the task of gaining access into the peritoneum, early control of bleeding and contamination, a thorough exploration of the abdominal cavity, and then either a damage-control approach with temporary abdominal closure or definite repair; the patient’s hemodynamic and physiologic …

What are the retroperitoneal zones of injury?

The retroperitoneum is divided into three main zones of injury: zone I is the central/midline retroperitoneum, zone II encompasses the perinephric space, and zone III comprises the pelvic retroperitoneum. Treatment of retroperitoneal hematomas varies depending on the anatomical location and mechanism of injury.

Which organ is most commonly injured in blunt abdominal trauma?

For blunt trauma injuries, the liver is the most commonly affected, followed by the spleen. The liver, as the largest organ, is more liable to injury.

How many types of abdominal trauma are there?

It is divided into two types blunt or penetrating and may involve damage to the abdominal organs. Injury to the lower chest may cause splenic or liver injuries.

What causes laparotomy?

A common reason for a laparotomy is to investigate abdominal pain, but the procedure may be required for a broad range of indications. The abdominal organs include the digestive tract (such as the stomach, liver and intestines) and the organs of excretion (such as the kidneys and bladder).

What are the indications for laparotomy?

Emergency conditions, such as those for acute intraperitoneal bleeding, uncontrollable gastrointestinal bleeding, blunt or penetrating abdominal injuries, generalised intraperitoneal sepsis due to perforated gastrointestinal tract are still the most common indications for laparotomy[3].

What is Mattox maneuver?

Definition. Mattox Maneuver, also known as a left medial visceral rotation, is a surgical step to explore and handle Zone 1 and 2 retroperitoneal injuries (aorta, left iliac and pelvic vessels). It starts with incising the parietal peritoneum at the white line of Toldt from the sigmoid colon to the splenic flexure.

What is a Zone 1 hematoma?

The retroperitoneum is divided into 3 anatomic regions that are utilized to guide therapy and describe the location of the retroperitoneal hematomas. Zone 1: The central retroperitoneum from the diaphragm superiorly to the bifurcation of the aorta inferiorly.

What are 4 potential problems of abdominal injuries?

Muscle guarding, back and flank pain, nausea, vomiting, and even shock are possible with significant trauma to the kidneys. With enough force transferred to the abdominal area, intestinal damage and even bowel perforation can occur.

What is blunt force trauma to the abdomen?

Blunt force trauma occurs when an object strikes the abdomen or the abdomen strikes against an object. A common example of this occurs during an automobile accident. During blunt trauma, the abdominal organs can be injured at three distinct times.

What is the most common cause of abdominal trauma?

[11] reported motor vehicle crashes (MVCs), fall from height and assaults to be the most common causes of blunt abdominal trauma. The penetrating trauma is mainly caused by gunshot, stab, and other objects that enter the peritoneal cavity.

How long does laparotomy incision take to heal?

Laparotomy may cause a red, painful, raised scar across the abdomen, and it may take 6–8 weeks for this scarring to heal. In some cases, the scar will fade over time, but in others, it may be permanent.

How are trauma patients positioned during the laparotomy?

Trauma patients should initially be positioned in the supine position with arms fully abducted at a 90° angle ( Fig. 27-1 ). If the patient is unstable, prepping and draping may occur before or simultaneously with intubation. At this time, other members of the team can work on venous and arterial access and the other issues noted above.

How many emergency laparotomies are performed each year?

A total of 268 index emergency laparotomies were evaluated. Total number of patients who presented with an abdominal AIS > 2 remained constant over the past 10 years, as did the percentage of patients that required an emergency laparotomy. Most were polytrauma patients with a mean ISS = 27.5 (SD ± 14.9).

What are the most common causes of laparotomies?

The most frequent indication for laparotomy was hemodynamic instability or ongoing blood loss (44%).Unplanned relaparotomies occurred in 21% of the patients, mostly due to relapse of bleeding. Other complications were anastomotic leakage (8.6%), intestinal leakage after bowel contusion (4%).

Which is the most common surgical procedure for abdominal trauma?

Laparotomy is one of the most common surgical procedures performed for abdominal trauma. The essence of a successful trauma laparotomy outcome relies on a methodical sequence of steps, surgical knowledge of maneuvers, and sound surgical decisions based on evidence and experience. Surgical maneuvers …