Spectrum of exploratory laparotomy for acute abdomen in a central Gujarat tertiary care centre

Arpan J. Prajapati; Sulove Singhal; Prathiti A. Jain; Adeesh P. Jain

doi:10.18203/2349-2902.isj20242766

Authors

Arpan J. Prajapati Department of Surgery, Medical College Baroda, Vadodara, Gujarat, India
Sulove Singhal Department of Surgery, Medical College Baroda, Vadodara, Gujarat, India
Prathiti A. Jain Parul Institute of Medical Sciences, Vadodara, Gujarat, India
Adeesh P. Jain SSG Hospital, Vadodara, Gujarat, India

DOI:

https://doi.org/10.18203/2349-2902.isj20242766

Keywords:

Exploratory laparotomy, Acute abdomen, Intestinal obstruction, Gastrointestinal perforation

Abstract

Background: Exploratory laparotomy is one of commonest emergency surgeries performed in the world. Despite technological advance imaging, the fundamental technique of exploratory laparotomy has remained unchanged over years. Studies quantifying the spectrum of laparotomy in central Gujarat are lacking.

Methods: A retrospective study of 249 patients of emergency exploratory laparotomy for acute abdomen in SSG Hospital Baroda from May 2022 to May 2024 was done and data involving clinical presentation, imaging, operative findings and post- operative course were studied and analysed. The cases were divided into gastro-intestinal perforation, gastro-intestinal obstruction and miscellaneous cause.

Results: The most common cause of exploratory laparotomy in study was perforation peritonitis including 59 ileal, 16 jejunal, 49 pre-pyloric, 29 duodenal, 1 body of stomach, 17 appendicular and 8 colon. With post op major complications like burst-11%, leak-5%, pneumonia-5%, multi-organ failure-6.5% and ileus 5%, wound infection 18%. The overall mortality was 15%. Out of 58 cases of laparotomy for obstruction including adhesions (29.3%), obstructed inguinal hernia (12%), tuberculosis (32%), malignancy (13.8%), internal hernia (12.6%). The miscellaneous causes were ruptured liver abscess (9), rupture ectopic pregnancy (2), twisted ovarian tumour (1).

Conclusions: Acute abdomen remains a significant surgical problem. Peptic perforation remains a common cause of acute abdomen with high morbidity and mortality, despite improves medical management, though there is a declining trend in incidence, tuberculosis remains an important cause.

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