Evaluation of the management of penetrating abdominal injuries - Lahore General Hospital Experience

Abstract

Objectives To study the changing pattern of penetrating abdominal injury, to check the effectiveness of management, to audit the associated morbidity and mortality and to suggest ways and means to improve serious outcome. Study Design: Prospective interventional. Place and Duration of study: Department of surgery Lahore General Hospital, Lahore from March 1998 to March 2004. Subject/Method: Exploratory laparotomy of all patients with history of penetrating abdominal injury with at least breach of peritoneum. Results: In a 114 20 patient exploratory laparotomy was performed their average pulse rate was 110 / min, systolic blood pressure 90 / mm Hg with Hb range of 5.5 gm / dl to 11.5 g / dl. There were 68% victim of firearm injury and 32%o were suffered from stab on exploration virtually no organ found to escape injury while 42 (10%) cases turned out to be negative with uneventful postoperative recovery. 94(24.2%) patients developed post operative complications while 42(10%) patients expired. Conclusion: Time should not be wasted in investigating unstable patients rather these should be resuscitated in Operation Theater and early exploratory laparotomy should be performed more sophisticated diagnostic facilities like ultrasound, CT, MRI, Endoscopy, selective angiography should be made available in emergency and there should be regular audit of all penetrating abdominal injuries.